Use of shockwave intravascular lithotripsy for the treatment of calcified renal artery stenosis in a symptomatic subject.

Aim: The use of shockwave lithotripsy for the treatment of heavily calcified atherosclerotic plaques before stenting showed great results in terms of feasibility and safety with favorable initial success. Evidence suggests that it is a useful tool to treat calcified lesions in peripheral and coronary arteries. Here, we describe the case of a patient with calcified renal artery stenosis successfully treated with the shockwave lithotripsy system. Case Report: We present a 76-year-old man with a known significant atherosclerotic renal artery stenosis and refractory hypertension. The patient received an angioplasty of the right renal artery in the first session and he was admitted for a second session to intervene in the left renal artery. The lesion was successfully treated with the lithotripsy system. Final angiography demonstrated an excellent position of the stent and good wall apposition. Conclusion: Our clinical case demonstrates that lithotripsy is safe and effective also for the treatment of the renal artery.

Renal Denervation: A New Approach to an Old Problem.

Renal sympathetic hyperactivity is associated with hypertension. Renal denervation is an interventional approach to selectively denervate the renal sympathetic fibers. The reduction of systolic and diastolic blood pressure in patients with resistant hypertension has been demonstrated in the Symplicity HTN-1 and HTN-2 trials. Before the patient undergoes an interventional procedure, causes of secondary hypertension or pseudoresistance must be excluded.