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Retrogression of a renal artery stenosis after a six months follow-up is reported in a 43 years old woman who stopped smoking after the first angiography and was treated with antiplatelet, suggesting spontaneous atherosclerosis injury revision.

A 66-year-old man with atrial fibrillation was referred soon after developing left lower limb and abdominal pain with rectal bleeding. An immediate flush aortogram showed embolic occlusion of the left distal superficial femoral artery and superior mesenteric artery (SMA), 3 cm from its ostium. Recombinant tissue plasminogen activitor (rtPA) 40 mg was selectively in stilled in the SMA in two boluses. Abdominal symptoms resolved within 48 h, and complete recanalization of the SMA was shown on angiography. Exploratory laparotomy after 72 h showed a normal small bowel and right colon, and was completed by femoropopliteal embolectomy. Six months later, the patient remained asymptomatic.

To evaluate the results of the association of a percutaneous transluminal renal angioplasty before a surgical revascularization of the infra-renal aorta.Percutaneous transluminal angioplasty of one (n = 12) or two (n = 2) renal arteries have been performed in 14 patients (11 hypertensive and one with azotemia), 2 to 240 days (mean 54) before infra-renal aortic surgery (aneurysms: 8, occlusive disease: 6).15 of the 16 dilatations were completely technically successful (residual stenosis less than 20%), with one groin hematoma treated medically. Mean duration of the surgical intervention were 137 minutes (occlusive disease) and 147 minutes (aneurysm). In the post-operative course were noted resolutive infections in two patients, and one death because of myocardial infarction. At the end of the follow-up (3 to 60 months, mean 32), all of the 13 patients alive had improved in terms of vascular disease. Hypertension was improved for 2 patients, stable for 10, worse for 1. Creatinine serum level was stable for 12 patients, and the renal insufficient was worsened.Combined percutaneous transluminal renal angioplasty and aortic revascularization seems to be reliable and safe; it can be an alternative to a simultaneous aortic and renal revascularization, notably for high-risk patients.