2025 Clinician Corner - Renal artery stent thrombosis as a complication of percutaneous renal artery revascularization and stent placement

Abstract 

We present the case of a 46-year-old man with bilateral renal artery stenosis and a previous stent placed on the left renal artery who presented with a hypertensive emergency with flash pulmonary edema, and acute-on-chronic renal failure. A renal angiogram revealed extensive thrombosis and in-stent restenosis, which were treated with thrombectomy, angioplasty, and stenting. Our case highlights the importance of careful patient selection for renal artery stenting and close monitoring poststenting due to the risk of serious complications.  

Keywords:  Complication; in-stent restenosis; renal artery stenosis; stent thrombosis; stents

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Faculty credentials/disclosure 

The planners and faculty for this activity have no relevant financial relationships to disclose. The patient consented to the publication of this report.

Process

Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

  • By completing this process, you are attesting that you have read the journal article.

Expiration date:

Credit eligibility for this article is set to expire on September 1, 2026.

Learning Objectives

After completing the article, the learner should be able to:

  • Carefully select patients for percutaneous transluminal renal angioplasty and stenting for renal artery stenosis, recognizing that the procedure benefits a limited subset of patients and has a risk of serious complications. 
  • Identify the importance of close follow-up in patients who undergo percutaneous transluminal renal angioplasty with or without stenting, recognizing the importance of medication compliance and monitoring to assess for the development of complications. 

Key Points 

  • Careful patient selection is essential for percutaneous transluminal renal angioplasty and stenting for renal artery stenosis, as the procedure benefits a limited subset of patients and has a risk of serious complications. 
  • After stenting, close follow-up is essential to ensure medication compliance and monitoring for the development of complications, and a high index of suspicion is needed to avoid a delay in diagnosis.  

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Course summary
Available credit: 
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
09/01/2025
Course expires: 
09/01/2026
Cost:
$25.00
Rating: 
0
  • Siddhant Passey, MD - Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA 
  • Shubhi Pandey, MD - Department of Cardiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA 
  • Aryan Mehta, MD - Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, Connecticut, USA 
  • Joyce Meng, MD - Department of Cardiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA 
  • Michael Azrin, MD - Department of Cardiology, University of Connecticut School of Medicine, Farmington, Connecticut, USA 

Corresponding author: Siddhant Passey, MD, Department of Internal Medicine, University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 (e-mail: [email protected]) 

Accreditation

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation

AMA PRA Category 1 Credit™

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS CC

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

ABIM MOC

 Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

 

Available Credit

  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
  • 1.00 American Board of Surgery (ABS) Accredited CME
    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.
  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance

Price

Cost:
$25.00
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