Endovascular Treatment of Renal Artery Bifurcation Stenoses with Branched Balloon Angioplasty

An 85-year-old man with left sided single kidney presented with end-stage renal failure after an acute intestinal bleeding. A complex bifurcational stenoses distally to a 6 months previously implanted ostial stent in the left renal artery was found on duplex imaging and angiogram. These two de-novo stenoses in the distal main renal artery and the proximal segment of the lower branch were simultaneously treated with a ultra-low profile, monorail bifurcation balloon catheter system (Avion Bifurcation RX2™, Invatec, Italy) that consists of a main vessel balloon (20/3.5mm) and a side vessel balloon (20/2.75mm). One day and three months postinterventionally, duplex ultrasound demonstrated no recurrent stenoses. Bifurcation balloon catheter systems for complex renal artery stenosis are discussed.

Keywords: Renal artery stenosis, Bifurcation balloon catheters, End-stage renal disease