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Management of L Renal Artery Stenosis in a Senior Male Patient

A 74-year-old male with vague abdominal pain underwent diagnostic imaging confirming L renal artery stenosis. No recent BP or medication changes. Past history includes HTN, CAD, type II DM, asthma. Recent interventional procedure detailed.

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Management of L Renal Artery Stenosis in a Senior Male Patient

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  1. History & Physical • 74 yo male recently c/o vague abd pain to PMD and underwent CT abd. This was suggestive of L renal artery stenosis and outside MRA obtained which confirmed this. No recent change in BP meds or other medical problems. Otherwise asymptomatic • PMH: HTN, CAD s/p CABGx3 in ‘99, type II DM, asthma, • Meds: diovan, lotensin, diltiazem • Exam: palpable distal pulses, no abdominal bruits • Duplex: R kidney 10.7cm, L kidney 11.9 cm, origin PSV 1.99m/s, mid L renal PSV 4.49m/s and EDV 2.06m/s, abnormal acceleration times in subsegmental branches • Labs: Creat=1.0

  2. SOS-omni catheter to select L renal

  3. 5F glide cath over angled glidewire

  4. 6F RDC guiding sheath

  5. BMW 0.014” wire

  6. 4x2 balloon Post-balloon: residual stenosis

  7. 6x20 balloon expandable stent

  8. Proximal edge of stent

  9. Final Run

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