A. Holden, A. Hill, M.R. Jaff, H. Pilmore Kidney International

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Presentation transcript:

Renal artery stent revascularization with embolic protection in patients with ischemic nephropathy A. Holden, A. Hill, M.R. Jaff, H. Pilmore Kidney International Volume 70, Issue 5, Pages 948-955 (September 2006) DOI: 10.1038/sj.ki.5001671 Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 1 Long-term response of reciprocal sCRN to renal angioplasty with protection for mild, moderate, and severe pretreatment CRI groups. Kidney International 2006 70, 948-955DOI: (10.1038/sj.ki.5001671) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 2 Response in reciprocal sCRN to renal angioplasty with protection – actual response after intervention (bold line) and projected reciprocal sCRN without intervention (dotted line). Kidney International 2006 70, 948-955DOI: (10.1038/sj.ki.5001671) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 3 Stent revascularization with distal protection of a solitary functional kidney. (a) Primary passage of a distal filter (arrow) through a critical stenosis via a guide catheter, deployed in the distal main renal artery (arrow). (b) Accurate positioning of a balloon expandable stent (Palmaz Genesis stent, Cordis Endovascular) at the renal artery ostium. Note the atheromatous abdominal aorta (arrow) as a potential embolic source. (c) Primary stenting of the left renal ostial stenosis with a balloon expandable stent (Palmaz Genesis stent, Cordis Endovascular) and the distal filter in place. Kidney International 2006 70, 948-955DOI: (10.1038/sj.ki.5001671) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 4 Bilateral atherosclerotic renal artery stenoses treated with stent revascularization with distal protection. (a) Contrast-enhanced magnetic resonanceangiography confirms bilateral ostial renal artery stenoses (arrows), more severe on the left. (b) Primary passage of a distal filter (Angioguard XP, Cordis Endovascular, arrow) via a guide catheter is possible on the right. (c) Primary stenting of the right renal ostial stenosis with a balloon expandable stent (Palmaz Genesis stent, Cordis Endovascular, arrow). (d) The more severe left renal ostial stenosis required initial passage of a 0.014inch ‘buddy wire’ (long arrow) before coaxial passage of a filter (short arrow). (e) Post-stenting angiography. Note the poor flow through the filter (arrow) due to embolic debris. (f) Recaptured distal protection filter with macroscopic atheromatous embolization material. Kidney International 2006 70, 948-955DOI: (10.1038/sj.ki.5001671) Copyright © 2006 International Society of Nephrology Terms and Conditions

Figure 5 Stent revascularization with distal protection of a solitary functional kidney. (a) Primary passage of a distal filter via a guide catheter (Filterwire EZ, Boston Scientific, arrow). (b) Primary stenting with a balloon expandable stent (Express SD stent, Boston Scientific Corporation, arrow). Kidney International 2006 70, 948-955DOI: (10.1038/sj.ki.5001671) Copyright © 2006 International Society of Nephrology Terms and Conditions