PTA of a renal artery stenosis with a new embolization protection device: Evidence of side-branch occlusion due to distal embolization — A case report

Abstract

Percutaneous angioplasty (PTA) and stenting is established and beneficial for treatment of hypertension caused by renal artery stenosis. The incidence and clinical implications of distal embolisation by liberation of atherosclerotic plaque material during renal intervention is unknown. We report on our first clinical application of a new embolization protection device (AngioGuard) in one patient with significant left renal artery stenosis. The AngioGuard consists of a 0.014 guidewire with a emboli filter basket at the distal part to capture and retreat embolic plaque debris. After device placement distal to the lesion we performed the PTA and stenting of the lesion in a standard manner. During the intervention we observed the occlusion of a renal side-branch caused by the completely filled emboli protection basket. The captured debris could be successful if extracted with the AngioGuard wire and normal blood-flow (TIMI 3) without filling defects was reestablished. The macroscopically visible particles measured up to 2.1×1.8 mm and were histologically analysed.