Successful wallstent implantation for extensive latrogenic renal artery dissection in a patient with fibromuscular dysplasia

Purpose: To describe a case of renal artery stenosis with fibromuscular dys plasia (FMD) and extensive iatrogenic dissection treated with Wallstent imp lantation. Methods and Results: An 83-year-old woman with a history of coronary artery disease and hypertension presented at another facility with exertional ang ina and poorly controlled hypertension. Renal arteriography uncovered a cri tical right renal artery stenosis with severe FMD. However, angioplasty res ulted in extensive dissection of the renal artery, for which the patient wa s referred to our institution. The renal artery was recanalized via the lef t brachial approach with restoration of flow using a Wallstent and a Palmaz stent. The patient's blood pressure was controllable after this procedure, and follow-up duplex imaging with flow velocities at 6 months showed paten t right renal artery stents. Conclusions: Owing to its length and flexibility, the Wallstent endoprosthe sis was a useful treatment modality in this case of extensive renal artery dissection.