Successful hybrid procedure in flash pulmonary edema

الملخص EN

A 70-year-old lady with recurrent flash pulmonary edema and acute coronary syndrome was detected to have bilateral renal artery disease and uncontrolled hypertension.

Her right kidney size was 9.3 Χ 3.2 cm [glomerular filtration rate (GFR) 32.65 mL/min], left kidney size was 6.8 Χ 2.9 cm (GFR 12.78 mL/min), with a total GFR of 45.43 mL/min.

Angiogram showed significant bilateral atherosclerotic renal artery stenosis and 90% right coronary artery lesion.

She underwent successful percutaneous transluminal angioplasty of right renal artery lesion.

Her serum creatinine of 1.6 mg/dL (GFR 45.43 mL/min) came down to 1.3 mg/dL (GFR 63 mL/min) post procedure and her blood pressure was controlled.

She then underwent percutaneous transluminal coronary angioplasty of right coronary artery lesion.

Renal artery stenosis is an important cause of uncontrolled hypertension and progression to chronic kidney disease.

An early intervention and prompt revascularization prevents recurrent flash pulmonary edema and end stage kidney failure.