Stabilization of renal function, improvement in blood pressure control and pulmonary edema symptoms after opening a totally occluded renal artery

Stenting has emerged as a procedure associated with low mortality and morbidity for symptomatic renovascular disease. However, percutaneous revascularization of chronically occluded renal arteries has not been reported. We report a case of a patient with refractory hypertension and congestive heart failure with unilateral occlusion of the left renal artery. Renal radionuclide scintigraphy with Tc-MAG3 showed residual left renal function for which percutaneous revascularization and stenting were successfully performed with improvement in symptoms and blood pressure control. Following recanalization, the presence of collateral vessels through the capsule of the kidney was noted, possibly maintaining viability of the renal parenchyma. This is a case of percutaneous revascularization of a chronic total occlusion leading to improvement in hypertensive and congestive symptoms.