Preventive Stent Placement for Renal Artery Stenosis Prior to Emergent Coronary Artery Bypass Grafting

Abstract

Purpose:

To illustrate the benefits of treating severe renal artery stenosis in renally compromised patients prior to surgery for coronary artery disease.

Case Report:

A 63-year-old woman with unstable angina, severe coronary artery disease, and long-term severe renal impairment with a single functioning kidney underwent renal stent placement for high-grade renal artery stenosis prior to coronary artery surgery. The procedure improved her serum creatinine from 528 µmol/L at baseline to 385 µmol/L, and she subsequently underwent coronary artery bypass grafting without deterioration in her renal function. At 1 year, the patient has a serum creatinine of 400 µmol/L, and there is no evidence of in-stent stenosis.

Conclusions:

Percutaneous renal angioplasty or stenting prior to coronary surgery in patients with concomitant renal and coronary artery disease may reduce perioperative renal deterioration in this specific group of patients.