Renal Angioplasty and Stenting

Narrowing or blockage of the renal artery (the main blood vessel that supplies the kidneys) can cause severely high blood pressure or problems with kidney function. Angioplasty is a procedure that uses a small balloon to widen the passage through a blood vessel. A stent is a small metal mesh tube put into a blood vessel to help hold it open. Renal angioplasty and stenting can help improve blood flow to the kidney and relieve problems. The procedure is often done by a specially trained doctor like Dr. Jamnadas.

Follow any instructions you are given on how to prepare, including:

• Do not eat or drink for 6 hours before the procedure.
• Tell the technologist what medications, herbs, or supplements you take; if you are, or may be, pregnant; or if you are allergic to contrast medium (x-ray dye) or other medications.

• You’ll change into a hospital gown and lie on an x-ray table. An IV (intravenous) line is started to give you fluids and medications. You may be given medication through the IV to help you relax.
• The skin at the insertion site (usually at the groin) is numbed with local anesthetic. Then, a needle with a thin guide wire is inserted through the skin into the blood vessel. A catheter (thin, flexible tube) is placed over the guide wire into the blood vessel.
• Contrast medium is injected into the blood vessel. Using x-ray images as a guide, the radiologist moves the catheter through the blood vessels to the kidney.
• When the catheter reaches the narrowed or blocked area, a special balloon attached to the catheter is inflated. This widens the artery (angioplasty). This part of the procedure may be done more than once with balloons of different sizes.
• To hold the blood vessel open, a stent may be inserted. To do this, a catheter with a stent attached is threaded over the guide wire. When the stent reaches the narrowed area, it is opened. The stent stays in the artery and the catheters and balloons are removed.
• When the procedure is done, pressure is put on the insertion site for 15 minutes to stop bleeding.

• Bruising at the insertion site
• Bleeding internally or around the insertion site
• Damage to the artery, including worsening of blockage
• Problems due to contrast medium, including allergic reaction or kidney damage

• You may be told to lie flat and keep the leg with the insertion site straight for 6 hours to prevent bleeding.
• You may stay in the hospital overnight.
• Drink plenty of fluids to help flush the contrast medium from your system.
• After you go home, care for the insertion site as directed.
• If you have a stent, you may need to take aspirin or anticoagulant medication after the procedure to help prevent blood clots. Talk to your doctor about this.