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Percutaneous renal artery angioplasty and stent placement have demonstrated safety and effectiveness in the treatment of selected patients with renovascular hypertension and ischemic nephropathy. Major complications have been predominantly confined to the affected renal artery and kidneys, including renal artery dissection and/or thrombosis, distal embolization, and contrast-related nephropathy. We report a case in which treatment of an ostial renal artery lesion with placement of a balloon-expandable stent was complicated by the development of an acute Type B aortic dissection. [ABSTRACT FROM AUTHOR]

Percutaneous transluminal angioplasty is increasingly used in children. We present a case of successful balloon angioplasty of an occluded surgical splenorenal shunt in a 4-year-old child who underwent liver transplantation because of biliary atresia. Percutaneous reopening of the shunt is a relatively safe procedure that may spare patients of surgical intervention. [ABSTRACT FROM AUTHOR]

The article comments on a study associating failed surgical renal revascularization with dialysis dependence. The burgeoning of the dialysis population in the U.S. is foreseen, which may represent the history of untreated renovascular atherosclerotic disease. Although primary operative renal revascularization has declined, the volume of renal angioplasty procedures has increased.

In this article the authors discuss the risk found in the angioplasty and stenting for renal artery lesions (ASTRAL). They muse on the controversial role of percutaneous transluminal renal angioplasty (PTRA)/stenting in renal artery stenosis (RAS) despite the findings. The authors conclude that there is no treatment that fits all but the complex pathophysiologic processes involving RAS require treatment modalities that must be individualized.