# A Case of Surgical Revascularization in a Patient with Uncontrolled Renovascular Hypertension and Renal Dysfunction after Repeated Percutaneous Transluminal Renal Angioplasty (PTRA) for More Than 10 Years

## TL;DR

A patient with long-term kidney artery blockage and high blood pressure was successfully treated with surgery after repeated non-surgical procedures failed.

## Contribution

This case highlights surgical revascularization as a viable option for long-term PTRA failure in renovascular hypertension.

## Key findings

- The left renal stent was completely occluded, and the right was 75% stenosed after repeated PTRA.
- Aorto-renal artery bypass restored blood flow and resolved renovascular hypertension.
- Surgical intervention was effective after long-term stent failure.

## Abstract

Percutaneous transluminal renal angioplasty (PTRA) is a treatment for renovascular hypertension due to renal artery stenosis. However, postoperative complications in stent re-stenosis/occlusion may occur frequently. A 60-year-old male patient presented to our hospital with uncontrolled hypertension and a deterioration of renal function. He had undergone an initial renal stenting 10 years earlier, followed by repeat PTRAs during follow-up for in-stent restenosis. The left renal stent was found to be completely occluded, while the right renal stent was found to be 75% stenosed. We performed an aorto-renal artery bypass. The bypass was patent without stenosis and the renovascular hypertension was recovered.