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Renal angiography and renal angioplasty

 


RENA_1

A renal angiogram is an imaging test that uses x-rays and a special dye to see inside the arteries that supply the kidneys. The purpose is to diagnose and see any blockages or stenoses (narrowing). 

Once an angiogram has been completed, and a blockage or stenosis has been confirmed, if it is appropriate, treatment can commence. Treatment options include angioplasty or stenting. Your interventional radiologist will determine which treatment is best suited for you and discuss the options during the consent process.

Angioplasty

Percutaneous Transluminal Angioplasty (PTA) is the opening of a stenosed (narrowed) or blocked blood vessel using a balloon catheter. The balloon inflates to a specific size, forcing the blood vessel to expand.

In most cases the artery will remain open following the balloon inflation. Sometimes however, the artery does not respond well to a balloon catheter, and in that case, the next step would be to place a stent in the artery.

The images from a renal angioplasty look as follows:

Rt Renal Artery(copy)(copy)

RENA 2(copy)Stenting

If an angioplasty has been unsuccessful, or a recurrent stenosis persists, a stent will then be inserted so the artery can remain patent.

A stent used in the artery is a metal, mesh like tube made from either nitinol (nickel-titanium alloy) or cobalt chromium. 


 

 

During the Procedure

A renal angiogram is performed by an interventional radiologist. During the procedure you will be sedated but awake. Local anaesthetic will also be injected around the access site

The area around your groin will be painted with an antiseptic solution, and a sterile drape will then be placed over your body, to ensure sterility is maintained. Local anaesthetic will be injected around the artery in your groin. This will sting for approximately 30 seconds, but after this, you should not feel any pain. If at any time you feel pain, or discomfort, please inform the doctor immediately, and more pain relief can be given via your IV line, as well as more local anaesthetic.

Using ultrasound guidance, the artery in the groin will be accessed, and a small hollow tube (sheath) will be inserted into the artery. Using contrast dye and fluoroscopy, angiograms will take place.

If the blockage or narrowing can be treated, wires and catheters will be used to cross the lesion, and treatment will commence. Please inform the doctor if you have pain, and it is not going away. More pain relief can be given.

Once treatment of the lesion has been completed, a device will be used to close the hole made in your artery. This will mean that you can start to sit up, an hour after your procedure has been completed.

After the Procedure

  • The sheath is removed and either pressure is applied to your groin to stop bleeding, or a closure device is used to close the hole in your artery.
  • The interventional radiologist will discuss the outcome of the procedure with you, or your specialist will discuss the findings further with you at a follow-up appointment.
  • Patients are usually monitored for 4 hours and must remain on bedrest during that time to reduce the risk of bleeding from the groin site.
  • You should be able to eat, drink, and take your normal medicines. 
  • Before you leave, a nurse will give you discharge instructions to follow at home.

What are the risks?

As with any procedure, there are potential risks involved. Your interventional radiologist will explain the procedure, discuss possible risks and answer any questions you may have. You will then be asked to sign the consent form.