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June 26, 1987

Rupture of the Renal Artery After Percutaneous Transluminal Angioplasty-Reply

Author Affiliations

Cleveland Clinic Foundation
Shadyside Hospital University of Pittsburgh

Cleveland Clinic Foundation
Shadyside Hospital University of Pittsburgh

JAMA. 1987;257(24):3365. doi:10.1001/jama.1987.03390240070023

In Reply.—  We agree with Dr Kaufman that angioplasty should never be performed simply because an anatomic lesion has been discovered and that a surgeon should be available in most cases should a complication arise during percutaneous transluminal angioplasty. However, in this particular case, the patient had severe congestive heart failure and unstable angina pectoris and would never have tolerated surgical intervention had it become necessary. If angioplasty had not been performed, she would have been relegated to chronic dialysis, in which the prognosis is particularly poor for patients with atherosclerotic renal artery disease. In the study by Novick et al,1 the mean survival time for patients on dialysis was 8.7 months, compared with 96 months for those who underwent surgical revascularization. We felt that since the patient was not a candidate for surgery, any measure to restore renal function was worth the risk.With reference to the comments