Renal artery angioplasty is a procedure to widen the opening of the renal arteries that supply blood to the kidney. Narrowing of the renal artery (renal artery stenosis) is the leading cause of this artery obstruction. Renal artery stenosis is mostly caused by atherosclerosis or fibrous disease of the arteries. When the renal artery is blocked, the blood flow to the kidney is affected. Angioplasty aims at opening the block and restoring the regular blood flow. The kidney manages the amount of salt and fluid in the body by filtering the blood. When the blood fails to enter the kidney to remove salt and water, there is the retention of fluid in the body. Moreover, the kidney releases the hormone renin that helps retain salt and water, and causes the blood vessels to stiffen. Stiffening of the blood vessels results in building up of pressure, leading to renovascular hypertension.
Why do I need renal artery angioplasty?
You may need renal artery angioplasty if you have the following conditions:
- Sudden onset of renovascular hypertension
- Renovascular hypertension without a positive family history
- Renovascular hypertension without a medical history of factors known to cause hypertension
- Renovascular hypertension unmanageable with drugs
- Noncompliant to the medications
- Kidney failure
- A decline in kidney function
- Unmanageable renovascular hypertension
- Congestive heart failure
- Unstable angina (a condition where your heart doesn’t get enough blood flow and oxygen)
- The recent development of end-stage kidney disease
How will I know if I need renal artery stenting?
The physician may order certain tests to identify whether you require renal angioplasty. Some of them include:
- Angiography: This test uses a catheter to identify the site of obstruction in the renal artery.
- Magnetic resonance angiography: Similar to magnetic resonance imaging (MRI), magnetic resonance angiography uses a large magnet to create images of the kidney.
- Computed tomography angiography: This test uses a series of cross-sectional X-rays to build a three-dimensional image of the kidney.
- Duplex Doppler ultrasonography: This test uses sound waves to measure the size of the stenosis within the renal arteries.
How is renal artery angioplasty done?
During renal artery angioplasty, the physician may follow the below procedure:
- The physician makes an incision in the groin through which a catheter is inserted.
- The physician guides the catheter carefully to the narrow part of the renal artery.
- Next, the physician places a guidewire with a balloon on its tip through the catheter to the spot in the block in the artery.
- The physician inflates the balloon to open the blockage.
- Finally, the physician presses a stent into the artery wall.
- The physician leaves the stent in the artery to keep it open to maintain the blood flow.
What are the risks of renal artery angioplasty?
As with any other procedure, there are few risks associated with renal artery angioplasty:
- Bruising at the site where the catheter was placed
- Bleeding in or around the insertion site
- Damage to the artery
- Blood clots
- Kidney failure
- Stent misplacement
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