Retrograde Recanalization for Proximal Occlusion of the Right Renal Artery through a Compensated Collateral Artery in a 10-year-old Patient

Ann Vasc Surg. 2022 Jan:78:379.e1-379.e5. doi: 10.1016/j.avsg.2021.06.032. Epub 2021 Sep 3.

Abstract

Background: To describe a retrograde recanalization for the proximal occluded lesion in right renal artery (RRA) in young patient with fibromuscular dysplasia (FMD).

Methods: A 10-year-old girl presented to our hospital with proximal RRA occlusion and refractory hypertension though she took anti-hypertension medicines. Her renin and aldosterone were beyond the normal level in both base state and excited state. Her glomerular filtration rate at right kidney was only 18.4 ml/min. Angiography revealed proximal RRA occlusion and a compensated collateral artery (CCA) from the infrarenal aorta to the RRA. She was thus diagnosed with focal FMD. A retrograde recanalization was performed through this CCA.

Results: Angioplasty and stenting were successfully performed to treat the proximal RRA occlusion. Postoperatively, the glomerular filtration rate in the right kidney improved. One-year follow-up revealed that, the blood pressure maintained at normal range without any antihypertensive agents. No other discomfort was complained.

Conclusions: It is feasible to establish a working pathway with patient's compensated collateral artery to treat the renal artery occlusion.

Keywords: Endovascular Repair; Renal Artery Occlusion,Renovascular Hypertension; Retrograde Recanalization.

Publication types

  • Case Reports

MeSH terms

  • Angioplasty, Balloon* / instrumentation
  • Blood Pressure
  • Child
  • Collateral Circulation*
  • Female
  • Fibromuscular Dysplasia / complications*
  • Fibromuscular Dysplasia / diagnosis
  • Fibromuscular Dysplasia / physiopathology
  • Humans
  • Hypertension, Renovascular / diagnosis
  • Hypertension, Renovascular / etiology
  • Hypertension, Renovascular / physiopathology
  • Hypertension, Renovascular / therapy*
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / etiology
  • Renal Artery Obstruction / physiopathology
  • Renal Artery Obstruction / therapy*
  • Renal Circulation*
  • Stents
  • Treatment Outcome