Intravascular Lithotripsy and Dual Drug-Coated Balloons for the Treatment of Severely Calcific Renal In-Stent Restenosis: All Is Fair in War
| Autor: | Bernardo Cortese, Gaetano Di Palma |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Lithotripsy Coronary Angiography Balloon Coronary Restenosis 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Restenosis Angioplasty medicine.artery medicine Humans 030212 general & internal medicine Right Renal Artery Angioplasty Balloon Coronary Renal artery business.industry General Medicine Middle Aged medicine.disease Pharmaceutical Preparations Paclitaxel chemistry Sirolimus Radiology Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Cardiovascular Revascularization Medicine. 28:193-196 |
| ISSN: | 1553-8389 |
| Popis: | Optimal treatment of renal artery "in-stent restenosis" (ISR) is still debated; drug eluting stents (DES), drug coated balloons (DCB) and scoring balloons have all been used, with mixed long term results. The shockwave lithotripsy for the treatment of heavily calcified atherosclerotic plaques has proven to be an effective tool and preliminary data support its use in case of underexpanded stents. Here we present the case of a 60 year old male with a known significant atherosclerotic renal artery stenosis and refractory hypertension who already underwent bilateral renal angioplasty with bare metal stents (BMS) in 2011 and angioplasty with DCB in 2012 for right renal artery ISR. In May 2020 he presented with worsening hypertension and CT scan showed total occlusion of the right with critical ISR of the left renal artery. Because of the high calcium burden he underwent balloon lithotripsy for plaque modification and subsequent renal angioplasty with sirolimus and paclitaxel DCB, with a good angiographic result. This is the first case of recurrent renal ISR successfully treated with Shockwave IVL and double-drug DCB therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect