Procedures
Indications
Conclusion
| Angiogram Renal Bilateral Selective | ||||
| Angioplasty-peripheral | ||||
Pre Procedure Diagnosis
| Post Procedure Diagnosis
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| Renal artery stenosis (CMS/HCC) [I70.1 (ICD-10-CM)] |
| Uncontrolled hypertension [I10 (ICD-10-CM)] |
Patent left renal artery 60 to 70% stenosis of proximal right renal artery Attempted percutaneous intervention of right renal artery stenosis . Plan: Return for percutaneous intervention of right renal artery via left radial approach. Bilateral groin areas were prepped and draped in a sterile manner. Access to the right common femoral artery was obtained under ultrasound guidance with a micropuncture needle and a 5 French sheath was placed. Non-selective angiography was initially performed with a Pigtail catheter followed by angiography of the left and right renal arteries with a 5 French Mikelson diagnostic catheter. Attempt to engage the right renal artery with a 5 Fr JR4 guide was unsuccessful. The right common femoral sheath was upsized to a 6 Fr sheath. Attempts to engage the right common femoral artery were made with a Mach 1 guide, IMA guide. The Mikelson catheter was used to engage the right renal artery and the artery was wired with a Miracle brothers wire then attempt to exchange the diagnostic catheter for an IMA guide resulted in loss of engagement of the wire. This was attempted again with a spartacore wire. Multiple attempts to perform catheter-based intervention of the right renal artery were performed but engagement of the artery was poor. Unfortunately, due to the angulation of the artery off of the aorta and the femoral approach is unable to gain enough support to complete angioplasty or stenting. Findings: Left renal artery patent. Right renal artery with a 60-70% proximal stenosis. Thank you for your help. Melissa |