June 26, 1987

Rupture of the Renal Artery After Percutaneous Transluminal Angioplasty

Author Affiliations

Albany (NY) Veterans Administration Medical Center

Albany (NY) Veterans Administration Medical Center

JAMA. 1987;257(24):3364. doi:10.1001/jama.1987.03390240070021

To the Editor.—  Olin and Wholey1 described the pathology of renal artery injury after angioplasty, but did not emphasize prevention of morbidity and mortality in the broader clinical application of this technique. At another academic institution, I observed three deaths directly related to renal artery angioplasty, two from aortic thrombosis and one from renal artery rupture. Several lessons stand out: These complications occurred with skilled angiographers, but without prior surgical consultation and at a time inconvenient for the availability of an operating room. A qualified surgeon should be available to assess these patients for major complications such as aortic thrombosis, arterial dissection, or retroperitoneal hemorrhage. Angioplasty should never be performed simply because an anatomic lesion has been discovered. If the proper diagnostic studies have not been done and absolute indications for angioplasty do not exist, the procedure should be deferred. Repeated arterial catheterization for a secondary procedure under controlled