PMC8792462_01
Selective right renal angiography before (A) and after (B) balloon angioplasty.
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F1
To confirm the diagnosis, renal angiography was performed (Figure 1).
Results of pressure guidewire measurement depicting Pa, Pd, and FFR before and after balloon angioplasty. This figure demonstrates a distal renal artery to proximal renal artery mean pressure gradient of 40 mm Hg and the FFR was 0.49. A significant increase in Pd was found after the pullback of the guidewire. Pa, mean aortic pressure; Pd, pressure distal to the stenosis; FFR, fractional flow reserve.
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F2
A significant increase of Pd was found after the pullback of the guidewire when across the lesions (Figure 2).
Optical coherence tomography (OCT) imaging revealed normal intimal (A), intimal hyperplasia (B), post-stenotic dilatation (C), and wavy endoluminal surface in the longitudinal reconstruction (D).
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F3
OCT (C7 XR, MA, USA, Abbott) showed that the minimal lumen area of the renal artery was 1.92 mm2 and the wavy endothelium of the right renal artery in longitudinal reconstruction and luminal stenosis due to intimal hyperplasia in cross-sectional imaging, which was compatible with pathognomonic for FMD (Figure 3).