Endovascular Treatment of Renal Artery Bifurcation Stenoses with Branched Balloon Angioplasty

a. Digital subtraction angiography reveals high-grade, complex stenosis at the renal bifurcation (black arrow) and in the lower side branch (white arrow). b. Simultaneous inflation of the double balloons in place (Avion Bifurcation RX2^®, Invatec). Main vessel balloon (3.5mm) placed in the main renal and lower branch renal artery (black arrow); side vessel balloon (2.75mm) positioned in the main and upper side branch renal artery (white arrow). c. Inflation of the double balloon more distally to treat a stenosis in the lower branch (white arrow) with the main vessel balloon (3.5mm). d. Result after withdraw of the balloons with both guide wires remaining in place.

Ultra-low profile balloon with 0.017-inch tip entry profile. Main vessel balloon with 2 markers (arrow) and side branch balloon with 3 markers (solid arrow).