Rescue endovascular revascularization in two patients with bilateral atherosclerotic renal artery occlusion]

Renal artery stenosis is found in 2% and 40% of general and high cardiovascular risk populations, respectively. Atherosclerotic renal artery stenosis (ARAS) has become an increasingly recognized clinical condition, especially in older or otherwise atherosclerosis-prone populations. This increase in prevalence has led to a dramatically increased use of percutaneous transluminal renal angioplasty. Randomized trials have failed to demonstrate any superiority of renal revascularization over medical therapy as far as control of hypertension, mortality or cardiovascular events is concerned. However, in this report we present two cases in which rescue endovascular revascularization in patients affected by bilateral ARAS permitted withdrawal from hemodialysis treatment and the restoration of a certain degree of renal function. In conclusion, for certain carefully-selected high-risk patients, renal revascularization may still have an important role. The two cases presented in this article are good examples of the extraordinary benefit that endovascular revascularization can bestow.