Renal artery calcifications can be associated with insufficient stent expansion and in-stent restenosis. Intravascular lithotripsy (IVL) uses shockwaves to disrupt calcium and treat calcific renal in-stent restenosis. Herein, the authors present a case to treat resistant reno-vascular hypertension and in-stent restenosis of an inadequately expanded renal stent in a patient with severe calcific renal artery stenosis. The patient was treated with IVL and stent dilation. The patient was followed subsequently, and her home blood pressure was well controlled on anti-hypertensive medications. In conclusion, IVL promises pronounced success in the modification of severely calcified renal artery lesions and can be used to treat renal artery stenosis even in the context of inadequately expanding renal artery stents.
Keywords: Intravascular lithotripsy; Percutaneous coronary intervention; Peripheral interventions; Renal artery calcifications; Renal artery stenosis.
Extensive calcifications can contribute to the blockages of the arteries of the kidney. These can be associated with insufficient stent expansion in patients undergoing stent placement. Intravascular lithotripsy uses high-energy shockwaves to disrupt calcium deposits of renal arteries. Herein, the authors present a case of high blood pressure refractory to four blood pressure medications associated with blockage of previously placed stent of the artery of the left kidney. This case demonstrates that lithotripsy is an effective procedure to modify calcifications in order to facilitate expansion of the stent to restore blood flow to kidneys.