Case Vignettes

Case 1. The Distressed Health Care Provider Mr MF was a 72 yo married father living independently with his wife. Mr MF was admitted electively for non-operative correction of a known left renal artery stenosis. Previous investigations reported two small kidneys with total obstruction of the right renal artery and > 60% obstruction of the left. Recent health was compromised by multiple admissions to Coronary Care (CCU) with chest pain and acute pulmonary edema (APO) despite recent plasty of a blocked coronary graft, placed in 2002. An Interventional Radiologist accessed the left renal artery. Unfortunately the tip of the catheter guide wire snapped off in the proximal part of the vessel, totally occluding it. An Interventional Cardiologist was unable to retrieve the remnant wire via a brachial approach. The entry site at the right brachial artery puncture developed a hematoma. The Vascular Surgeons opined that open revascularisation of the blocked renal artery was not an option.