Renal Angioplasty and Stenting
Renal angioplasty is a procedure that uses a small balloon to widen the passage through your renal artery. This is the main blood vessel that supplies your kidneys. A stent is a small metal mesh tube put into a blood vessel to help hold it open.
If your renal artery is narrowed or blocked, it can cause severely high blood pressure or problems with how your kidneys work. Renal angioplasty and stenting can help make blood flow to your kidney better and ease problems. The procedure is often done by a specially trained doctor called an interventional radiologist. This person is trained and certified by the American Board of Radiology to use minimally invasive image-guided procedures to diagnose and treat diseases.
Before your procedure
Follow any instructions you are given on how to get ready. This includes any directions you’re given for not eating or drinking before the procedure.
Tell your healthcare provider if you:
Are allergic to X-ray dye (contrast medium) or other medicines
Are pregnant or think you may be pregnant
Have any medical conditions
Have had any recent illnesses
Tell your healthcare provider about all medicines you take. You may need to stop taking some or all of them before the test. This includes:
All prescription medicines
Herbs, vitamins, and other supplements
Over-the-counter medicines such as aspirin or ibuprofen
During your procedure
You'll change into a hospital gown and lie on an X-ray table. An IV line is started. This is to give you fluids and medicines. You may be given medicine through the IV to help you relax.
Medicine will be put on the skin at the insertion site to numb it. The insertion site is often in the groin. Then a needle with a thin guide wire is put through the skin into the blood vessel. A thin, flexible tube called a catheter is placed over the guide wire into the blood vessel.
X-ray dye is injected into the blood vessel. The radiologist uses X-ray images as a guide. He or she moves the catheter through the blood vessels to your kidney.
When the catheter reaches the narrowed or blocked area, the radiologist inflates a special balloon attached to the catheter. This widens the artery (angioplasty). This part of the procedure may be done more than once with balloons of different sizes.
A stent may be put in to hold the blood vessel open. To do this, a catheter with a stent on it is threaded over the guide wire. The stent is opened when it reaches the narrowed area. The stent stays in the artery. The catheters and balloons are taken out.
When the procedure is done, pressure is put on the insertion site for 15 minutes to stop bleeding.
After your procedure
You may be told to lie flat and keep the leg with the insertion site straight for 6 hours to stop bleeding.
You may stay in the hospital overnight. If you don't stay in the hospital, you should have a friend or relative drive you home.
Drink plenty of fluids to help flush the X-ray dye out of your body.
After you go home, care for the insertion site as directed.
If you have a stent, you may need to take aspirin or a blood-thinning medicine (anticoagulant) after the procedure. This will help prevent blood clots. Talk with your healthcare provider about this.
Possible risks and complications
Bruising at the insertion site
Bleeding inside your body or around the insertion site
Damage to the artery, including the blockage getting worse and possible kidney damage
Problems because of X-ray dye, including allergic reaction or kidney damage
June 16, 2018
Clinical manifestations and diagnosis of chronic kidney disease resulting from atherosclerotic renal artery stenosis. UpToDate., Treatment of Unilateral Atherosclerotic Renal Artery Stenosis. UpToDate.
Fraser, Marianne, MSN, RN,Grossman, Neil, MD,Image reviewed by StayWell medical illustration team.