Potential of carbon dioxide angiography in the treatment of critical renal artery lesions in a patient with chronic kidney disease: a case report

The combination of atherosclerotic coronary and renal system lesions is quite common in clinical practice, while the risk of cardiovascular complications in such patients is tens of times higher than in the general population, which is associated with a sharp acceleration of vascular damage. The use of minimally invasive surgery, in particular endovascular renal artery revascularization, can improve excretory renal function and delay the need for renal replacement therapy. However, the use of nephrotoxic contrast agents in the presence of chronic kidney disease in a patient can become a key limiting factor for the use of endovascular treatment methods. The way out of this situation is the use of non-contrast endovascular surgery under the carbon dioxide angiography and intravascular imaging guidance. The article presents a case of successful balloon angioplasty and stenting of critical stenosis of the right renal artery in a comorbid patient under the carbon dioxide angiography and intravascular ultrasound guidance.