Pre-Intervention Work Up :
Pre-Intervention Work Up Color Doppler Renal ultrasonography .
Multiple Abdominal aortograms .
with edge detecting software .
3) Trans-stenotic pressure gradient .
Technique of angioplasty +stenting : :
Technique of angioplasty +stenting : Two different techniques :
- both under local anesthesia and I.V
sedation
- 5000 I.U heparin IA after sheath insertion
- I.V antibiotics in case of stenting .
- Cover the whole lesion by a stent .
First Technique: (fading) :
First Technique: (fading) Femoral , brachial or radial access.
8 F femoral sheath ,
Curved catheter (Simmons) on rigid stearable GW 0.020 .
Predilatation with balloon 5 – 8 mm *2cm.
Ipsilateral or contralateral 5F Catheter for injection .
Second Technique: (increasing) :
Second Technique: (increasing) Femoral , brachial or radial .
9 F femoral sheath .
8 F renal guiding catheter on ostium .
GW 0.020 , 0.014 , 0.018 curved tip .
Pre dilatation
Pass Guiding Catheter , stent then withdraw the G .Catheter .
Inject from the G . Catheter , 3 –way
Renal stent :
Renal stent Protrude 1 mm in the aorta ,
Dilated to diameter of the artery diastal to the lesion ,
The proximal part is overdilated by 1 mm .
Which stent :
Which stent Wallstent difficult to see
Palmaz stent ,
AVE stent ,
Angiostent , Platinum .
Corynthia stent .
.
Slide 8:
Thank You