"Sepal wire technique"- a novel technique for percutaneous transluminal renal angioplasty of aorto-ostial lesion.

Abstract

Renal artery stenosis (RAS) is the most common cause of secondary hypertension. Percutaneous transluminal renal angioplasty (PTRA) is associated with improved blood pressure control, preservation of renal function, and has a high technical success rate with an acceptable adverse event and restenosis rate. Aorto-ostial renal artery intervention remains a challenge, as precise positioning of stents using conventional angiographic landmarks is difficult. We describe a novel technique stent positioning for aorto-ostial lesion of renal artery that makes use of a simple additional workhorse wire curling back into the aorta like the sepal of a flower in a 61-year-old hypertensive male. PTRA using left transradial approach was performed by deploying 6x18 mm stent (Herculink, Boston, USA) by deploying at 8 atmospheres, and further flaring the ostium by little pulling up the balloon at 10 atmospheres obtaining adequate result. At 3-years follow-up by computed tomography, it was well opposed and patent.