Description of Event or Problem · 0
EVENT: RENAL ARTERY THROMBOSIS EVENT DESCRIPTION: A FEMALE PATIENT UNDERWENT ULTRASOUND RENAL DENERVATION PROCEDURE ON (B)(6) 2025. DURING THE PROCEDURE, MULTIPLE ATTEMPTS WERE MADE TO ACCESS THE CHALLENGING, TORTUOUS LEFT RENAL ARTERY USING THREE DIFFERENT PARADISE BALLOONS, WHICH REPEATEDLY DISLODGED DUE TO RESISTANCE CAUSED BY VESSEL TORTUOSITY. PARADISE CATHETER WAS NEVER INFLATED NOR WAS ANY SONICATION PROVIDED THE LEFT RENAL ARTERY. ALTHOUGH THE RETURNED DEVICES HAD TEARS WHICH APPEARED TO BE DUE TO TORTUOUS ANATOMY, THIS IS HIGHLY UNLIKELY RELATED TO THE ADVERSE EVENT. AS PER PHYSICIAN, THE ANTICOAGULATION DOSE WAS INADEQUATE. POST PROCEDURAL RENAL ANGIOGRAM NOTED A CLOT PARTIALLY OCCLUDING THE LEFT RENAL ARTERY. THE CLOT WAS TREATED WITH UNILATERAL THROMBECTOMY USING PENUMBRA PUMP (CAT6) WHICH RESTORED THE BLOOD FLOW. FOLLOWING THE THROMBECTOMY PROCEDURE, THE PATIENT WAS TRANSFERRED TO THE ICU. A CONTRAST-ENHANCED CT SCAN WAS PERFORMED NOTED AREAS OF INFARCTION IN THE LEFT KIDNEY. PATIENT CONDITION IMPROVED AND DISCHARGED UNDER STABLE CONDITION 3 DAYS LATER. SUBOPTIMAL ANTICOAGULATION DOSE ALONG WITH FORCED INSERTION OF PARADISE CATHETERS AGAINST CHALLENGING ANATOMY, ATHEROSCLEROSIS, AND VASCULAR INJURY FROM MULTIPLE DEVICES INCLUDING THE ACCESSORY DEVICES, LIKELY CONTRIBUTED TO THE EVENT.