Renal artery angioplasty and stent

What is a renal artery angioplasty and stent?

A renal artery is the main blood vessel to the kidney.

A renal artery angioplasty and stent is done to treat a narrowed renal artery. Using X-rays as a guide, a small plastic tube is put into the narrowed artery. A special balloon on the tube is blown up to open the narrowed part of the artery. An expandable tube called a stent is then put in to keep the artery open.

Benefits of a renal artery angioplasty and stent

• Used to treat an artery instead of using surgery.

Risks of a renal artery angioplasty and stent

Your doctor knows the risks of a renal artery angioplasty and stent and will advise you whether the benefits outweigh any possible risk.

There may be increased risk if you are taking some medications. These include anticoagulants (blood thinning medications) and anti-inflammatory medication.

Possible risks include:

• Extremely small chance you could develop cancer in the long term from the radiation. The amount of radiation you are exposed to depends on the number of pictures taken.
• An allergic reaction (usually mild and easily controlled by medication) to X-ray dye.
• Infection at the site of an injection.
• Occasionally the procedure does not work or may make the narrowing worse or cause a blockage.
• Occasionally the procedure may cause blockage to other arteries which can cause other problems. Very rarely this can cause death.

If you have any allergies, tell the staff or radiology doctor.

If you are at all concerned regarding the risks, talk to your doctor before the examination.

Preparation

• You will need to stay in hospital over night and will need to bring toiletries with you (for example, a toothbrush). The hospital you are staying in should let you know if there is anything else you need to bring.
• Bring your referral letter or request form and all X-rays taken in the last 2 years with you.
• Leave the X-rays with the radiology staff as the doctor may need to look at them. The radiology staff will tell you when these are ready to be picked up.
• Wear comfortable, loose clothing.
• Leave all jewellery and valuables at home.
• You may be asked not to eat for 4 hours before the renal angioplasty.
• You may be allowed to drink water. You will need to check this.

Just before the renal artery angioplasty and stent

• You may be given a gown to wear.
• You may be asked to remove any metal objects.
• You may have a needle put into the back of your hand if you are having a sedative during the procedure.

Tell your doctor before the scan

• If you are or may be pregnant.
• If you have any allergies and medical conditions.
• Any medications you are taking.

What happens during a renal artery angioplasty and stent

You will be asked to lie flat on your back on the X-ray bed. Staff will clean the skin on your groin or arm and place sterile drapes over you. They will then inject a local anaesthetic, which may sting a little.

A special tube is put into the artery in the groin or arm and passed into the renal artery. The dye is injected through the tube. The tube is X-rayed to make sure it is in the right place. The tube is moved into the narrowed part of the artery and another tube is put in which has a tiny balloon on it. This will be inflated to widen the narrowed part of the artery.

A stent is then put in over the balloon. Once the stent is in the right place the balloon is inflated. The balloon tube is then taken out and the stent is left in the renal artery. The tiny hole in the artery in your groin or arm will be pressed by one of the staff for about 15 minutes to block it.

Possible side effects of dye:

• You may feel a slight coolness and a flushing for a few seconds.
• Part of your body may feel warm – if this bothers you, tell the staff.

You should not feel any pain, but it may feel uncomfortable in your back when the balloon is blown up.

The renal artery angioplasty takes between 1 and 1½ hours, including the time taken to get you ready.

Consent

You have the right to refuse an examination and may do so if you wish. You will be asked to complete a consent form.

When will I get the results?

The amount of time it takes for you to get your results will differ depending on where you get your procedure done. The radiology doctor will look at the pictures and write a report. The pictures may be on films or on a CD.

Ask whether you should wait to take the pictures and report with you, or whether they will be sent to your doctor.

Your doctor will need to discuss the report with you. You will need to make an appointment to do this.

After a renal artery angioplasty and stent

You will be taken back to your ward on a trolley and will usually need to stay in hospital overnight. The nurse will check your pulse and blood pressure a few times and check your groin or arm in case there is any bleeding.

You may be given aspirin or other blood thinning medication to stop clotting near the stent.

The wound on your groin or artery may be a little sore when you go home. You will be told how to look after this.

• Staff will need to take out the needle if it is still in your arm.
• Staff will give you any special instructions.
• The dye will pass out of your body in your urine. You will not notice it as it is colourless.
• Drink plenty of fluid to help get rid of the dye.

If you had a sedative

• You must not drive a car or take public transport for 24 hours afterwards.
• You must have someone with you for 24 hours afterwards.
• You must not operate machinery for the rest of the day.

Costs of a renal artery angioplasty and stent

For an Australian patient in a public hospital in Western Australia:

• public patient – no cost to you unless advised otherwise
• private patient – costs can be claimed through Medicare and your health insurance provider

For a patient in a private hospital or private imaging site in Western Australia – ask your doctor or the staff where you are having your test done.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.