Intravascular ultrasound-guided shockwave lithotripsy of heavily calcified bilateral renal artery stenosis: a case report

• Published in: European heart journal : case reports Vol. 5; no. 1; p. ytaa568
• Main Authors: Yousif, Nooraldaem, Bardooli, Fawaz, Shivappa, Sadananda, Noor, Husam A
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01-01-2021
• Subjects: Angioplasty; Care and treatment; Case Report; Hypertension; Lithotripsy; Renal artery obstruction; Stenosis; Type 2 diabetes; Case report; Angioplasty; Pulmonary oedema; Intravascular shockwave lithotripsy; Intravascular ultrasound; Refractory hypertension; Renal artery stenosis
• ISSN: 2514-2119; 2514-2119
• DOI: 10.1093/ehjcr/ytaa568

Abstract
Background
Calcified lesions represent a hard obstacle to overcome in renal arteries, particularly when renal angioplasty represents the only feasible course of action in the setting of high-risk bilateral renal artery stenosis (RAS) with refractory systemic hypertension and recurrent flash pulmonary oedema.
Case summary
We herein report a case of symptomatic bilateral severely calcified RAS, treated successfully with intravascular ultrasound (IVUS)-guided coronary and peripheral intravascular shockwave lithotripsy systems and stenting.
Discussion
Intravascular shockwave lithotripsy is an attractive modality for the treatment of challenging, heavily calcified renal arteries that combines the calcium-disrupting capability of lithotripsy with the familiarity of balloon catheters to facilitate proper stent deployment.