Percutaneous stent-in-stent placement for renal artery stenosis of a solitary functioning kidney

Area of Science:

• Cardiovascular Medicine
• Nephrology
• Interventional Radiology

Background:

• Renal artery stenosis (RAS) is a significant cause of secondary hypertension, particularly in younger populations.
• Endovascular interventions, including stenting, offer effective treatment for RAS.
• In-stent thrombosis (IST) is a rare but serious complication following renal artery stenting.

Observation:

• A young patient presented with IST in a renal artery stent.
• The patient had a solitary functioning kidney, increasing the complexity of management.
• This case highlights the challenges of managing IST in a critical anatomical setting.

Findings:

• Successful treatment of IST was achieved using a stent-in-stent placement technique.
• This approach restored renal artery patency and preserved kidney function.
• The case demonstrates the feasibility of a less invasive salvage option for IST.

Implications:

• Stent-in-stent placement is a viable option for managing IST, especially in complex cases.
• Close follow-up of patients with renal artery stents is crucial for early detection of complications like IST.
• This case expands treatment strategies for a rare but potentially devastating complication of renal artery stenting.