A new temporary occlusion and aspiration system for prevention of distal embolization during percutaneous transluminal renal angioplasty

Cholesterol embolization has been described as a severe complication of percutaneous transluminal renal angioplasty (PTRA) and may lead to renal insufficiency with the need of transient or permanent hemodialysis. We describe a case of successful angioplasty of a renal artery in-stent restenosis utilizing a new temporary balloon occlusion and aspiration system for prevention of distal embolization. Histological examination of blood retrieved from the distally occluded vessel showed lipid-rich macrophages (foam cells) and an amorphic lipoid substance as markers of atherosclerotic plaque debris. Further studies are necessary to evaluate the clinical relevance of atheromatous microembolization and its renal function and clinical course following angioplasty.