RENAL ARTERY ANGIOPLASTY BY MOHAMED OMAR

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RENAL ARTERY ANGIOPLASTY : 

RENAL ARTERY ANGIOPLASTY Mr.Mohamed Omar El-Farok , M.Sc, FRCSENG,FRCSED

INDICATIONS : 

INDICATIONS Atheromatous Stenoses Fibromuscular Hyperplasia Arteritis Transplant Artery Stenosis

Renal angioplasty/stenting : 

Renal angioplasty/stenting Primary patency at 6-12/12 Stents: 75-85%, PTRA : 25-45% Van der Ven , Lancet 99 Baugmanter, Radiology 2000

APPROACH : 

APPROACH Femoral Brachial

TECHNIQUE : 

TECHNIQUE Adjunctive Medication: Heparin, Vasodilators Catheters: Cobra, Sidewinder Wires: Atraumatic tip, Microwires, Bentson Devices: Balloon, Stents

Complications : 

Complications 2.1-7.2% Bakker,Cardiovasc Interv Rad 99 Amor, J Endovas Surg,99 Lederman, AHJ,2001

Complications : 

Complications Access artery Angioplasty site Contrast-related Toolrelated

Slide 10: 

Femoral Brachial Axillary Radial Dissection, thrombosis, false aneurysm, A-V fistula, emboli (peripheral, cerebral), haematoma (nerve/vein compression) ACCESS ARTERY

Angioplasty Site : 

Angioplasty Site Dissection Thrombosis False aneurysm Rupture Retroperitoneal Haemorrhage

Tools : 

Tools Balloon rupture Wire kink/loss Stent migration/deformity

Stents : 

Stents Balloon expandable Low profile “monorail” systems Wide bore shaped sheath/guide catheters

Contrast Load : 

Contrast Load Nephrotoxicity even with low osmolar contrast Good hydration Gadolinium in cases of severe renal dysfunction

Slide 49: 

Gadolinium

Restenosis : 

Restenosis Much lower with stents Remains a problem Drug-impregnated stents ( Cypher )

Slide 51: 

October 2000 June 2001