Blood pressure improvement after stenting in an atherosclerotic renal artery stenosis patient with normal rFFR: A case report

Background: There is no consensus on the optimal hemodynamic assessment of renal artery stenosis patients to identify who is suitable for revascularization. Previous studies demonstrated the predictive value of renal fractional flow reserve (rFFR) and hyperemic systolic gradients in blood pressure (BP) improvement after stenting. This report describes BP improvement after stenting in 1 case of atherosclerotic renal artery stenosis with normal rFFR. Case presentation: A male with the complaint of uncontrollable hypertension was diagnosed with secondary hypertension due to atherosclerotic right renal artery stenosis. The rFFR was 0.96, and the translesion pressure gradient was within normal levels in the rest state but increased to 50 mm Hg in hyperemia. After stent implantation, his BP was normalized. Conclusions: The case highlights the significance of the assessment of hyperemic systolic gradients in atherosclerotic renal artery stenosis patients with normal rFFR to facilitate decision-making.