Renal angiography is an X-ray examination of the arteries supplying the kidneys, performed by passing a thin catheter from the groin or wrist and injecting contrast dye. If a significant narrowing (renal artery stenosis) is found, it can be widened with a balloon and held open with a metal stent in the same sitting.
Large trials have shown that for most people with narrowing caused by atherosclerosis, stenting does not protect the kidneys or lower blood pressure better than good medication. It is therefore reserved for selected situations. In fibromuscular dysplasia, a condition of younger women, balloon angioplasty without a stent often works well.
What Renal Artery Angiography and Stenting involves
The narrowing is usually identified first by Doppler ultrasound, CT or MR angiography. On the day, the interventional radiologist or cardiologist numbs the skin over the femoral artery in the groin, or the radial artery at the wrist, and inserts a short sheath. A catheter is steered under X-ray to the renal artery, contrast is injected and pressures may be measured across the narrowing. If treatment is justified, a guidewire is passed through, a balloon is inflated and a balloon-expandable stent is deployed at the origin of the artery. The access site is closed with a plug device or manual pressure. You start or continue aspirin, often with clopidogrel for 1 to 3 months.
Who is a good candidate for Renal Artery Angiography and Stenting?
The decision should be made jointly by a nephrologist or hypertension specialist and the interventionalist, after a trial of optimal medical treatment.
- Fibromuscular dysplasia with high blood pressure, typically treated by balloon alone
- Recurrent sudden (flash) pulmonary oedema with severe narrowing of both renal arteries
- Rapidly falling kidney function with severe narrowing to both kidneys or to a single functioning kidney
- Truly resistant hypertension despite three or more drugs with a tight, haemodynamically significant stenosis
- Narrowing of the artery to a transplanted kidney
Es ist normalerweise nicht die richtige Wahl, wenn:
- Stable blood pressure and kidney function on tablets, where trials show no added benefit
- A small, scarred kidney under about 7 to 8 cm that is unlikely to recover
- Mild or moderate narrowing under about 70 percent
- Severe contrast allergy or advanced kidney failure where contrast poses a disproportionate risk
- People unable to take antiplatelet drugs
Technikoptionen
- Diagnostic angiography with pressure measurement: Confirms how severe the narrowing truly is before any treatment.
- Balloon angioplasty alone: Standard for fibromuscular dysplasia; stents are kept for complications.
- Balloon-expandable stenting: Used for atherosclerotic narrowing at the artery origin, where balloon alone recoils.
- Carbon dioxide or low-contrast angiography: Reduces or avoids iodinated contrast in people with poor kidney function.
- Radial (wrist) access: Allows earlier walking and fewer groin bleeds in suitable anatomy.
Was passiert während Ihrer Behandlung
The procedure takes 45 to 90 minutes under local anaesthesia with light sedation. You lie flat on an X-ray table. Contrast injections give a brief warm flush. Balloon inflation may cause a short back or flank ache; tell the team if it is severe. Afterwards you lie flat for 2 to 6 hours if the groin was used, and drink or receive fluids to help clear the contrast.
Vorbereitung auf Ihre Reise
A single session is usual, with one night in hospital. Allow about 4 to 6 days: a day for kidney blood tests and review of your imaging, the procedure, then a creatinine check at 48 to 72 hours before you fly. Send existing CT or MR angiography in advance so that an unnecessary trip can be avoided if stenting is not indicated.
- Informieren Sie den Arzt über Medikamente, Allergien, Schwangerschaft oder Stillen und eine Vorgeschichte von Fieberbläschen, Keloidnarben oder Autoimmunerkrankungen
- Vermeiden Sie Alkohol, Aspirin und entzündungshemmende Schmerzmittel für ein paar Tage im Voraus, wenn Ihr eigener Arzt zustimmt, um Blutergüsse zu reduzieren
- Kommen Sie ohne Make-up auf dem Behandlungsbereich an und vermeiden Sie zwei Wochen vorher Sonnenliegen und starke Sonne
Genesung und Ergebnisse
Most people go home the next day. Avoid heavy lifting and strenuous exercise for about a week to let the puncture site heal. Bruising in the groin is common. Blood pressure tablets are adjusted over the following weeks; do not stop them on your own. Kidney function and blood pressure are rechecked at 1 to 2 weeks, and a Doppler ultrasound at 6 to 12 months looks for re-narrowing within the stent.
- Back to everyday activity: About 1 week without heavy exertion
- When results show: Blood pressure response judged over 2 to 8 weeks
- How long they last: Stents last for years; some re-narrow and need repeat treatment
Sicherheit, Risiken und Revisionspolitik
Major complications occur in a few percent of cases and are more likely in people with widespread arterial disease.
- Bleeding, haematoma or false aneurysm at the puncture site
- Contrast-related fall in kidney function, usually temporary
- Cholesterol embolisation, in which debris showers into the kidney or legs and can permanently worsen kidney function
- Tear (dissection), blockage or rupture of the renal artery, rarely needing emergency surgery or causing loss of the kidney
- Re-narrowing inside the stent in roughly 10 to 20 percent over time
- Allergic reaction to contrast
- No improvement in blood pressure or kidney function despite a technically successful stent
Jeder schriftliche Vorschlag wird durch Clinic-Y gibt an, was die Klinik abdeckt, wenn eine Korrektur erforderlich ist. Fragen Sie danach, bevor Sie buchen, nicht danach.
Cost of Renal Artery Angiography and Stenting in Türkiye
Clinic-Y does not publish a single price for Renal Artery Angiography and Stenting, because the honest figure depends on your case. What moves it:
- Diagnostic angiography only, or angioplasty with one or more stents
- Treatment of one or both renal arteries
- Prior imaging and blood tests that need repeating
- Length of stay and any closure device used
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Häufig gestellte Fragen
Will I be able to stop my blood pressure tablets?
Usually not entirely after stenting for atherosclerosis, although doses may fall. In fibromuscular dysplasia, a cure or clear improvement is more common, especially in younger patients.
Can a CT scan replace angiography?
CT or MR angiography is normally enough for diagnosis. Catheter angiography is kept for when treatment is planned or results conflict.
I was told I have a narrowed renal artery. Do I need a stent?
Most people do not. Good control of blood pressure, cholesterol, smoking and diabetes matters most; stenting is for the specific situations listed above.
Is this the same as renal denervation?
No. Renal denervation uses energy to interrupt nerves around normal renal arteries to lower blood pressure. It is a different procedure with different indications.