PMC6080639_01
Pre-occlusive stenosis of the right aorto-renal bypass and moderate stenosis of the left aorto-renal bypass; the angiographic result after placement of balloon expandable stents.
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Torque  Guidewire (Boston Scientific) followed by deployment of balloon expandable stents in the proximal anastomosis on the right and at the middle portion of the bypass on the left (Express  SD Renal Monorail  6 x 18 mm on the right and 5 x 19 mm on the left; Boston Scientific [Fig. 1]). The procedure was uneventful.
Computed tomography angiography showing patency of both stents.
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A recent computed tomographic angiogram (CTA) showed patency of both stents (Fig. 2).
PMC6080639_02
Computed tomography angiography revealing a stenosis of the aorto-renal bypass.
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After three years of follow up, a deterioration in renal function was observed (blood creatinine increased from 1.4 mg/dL to 2.5mg/dL) and a CTA revealed severe stenosis of the renal venous bypass (Fig. 3).
Angiography documenting the stenosis of the aorto-renal bypass and the final result, after covered stenting.
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TempoTMAqua 5 F Cobra C2 catheter (Cordis, Bridgewater, NJ, USA). Then, a 4 x 20 mm balloon (Advance ; Cook Medical) was advanced for predilation and, finally, an Atrium Advanta V12 5 x 22 mm covered stent (Maquet, Rastatt, Germany) was placed across the stenotic region (pre-rupture pressure was necessary for a good angiographic result; Fig. 4).
Computed tomography angiography demonstrating covered stent patency.
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The control CTA confirmed stent patency (Fig. 5).