Case report. A 70-year-old woman with a history of smoking, hypertension and hyperlipidemia was referred for evaluation of exertional angina that had developed over the preceding 6 months. Thirteen years earlier, she had undergone balloon angioplasty of the mid-RCA following acute myocardial infarction. That procedure resulted in an acceptable final residual stenosis (estimated to be 25% by visual severity), but was notable for the creation of a longitudinal dissection at the angioplasty site. Current diagnostic cardiac catheterization documented the presence of a disrupted-looking s

EDITOR’S NOTE: This article by Diaz et al. contains extremely valuable information. The importance of assessing the “dynamic anatomy” of the popliteal artery (and other vessels) was only recently appreciated as a result of developments with endovascular therapy and the increasing use of fracture-prone intraluminal metallic stents. The findings described by the Argentinian group should prove useful to interventionists who are planning to perform a stenting procedure in a given patient. But even more so, they will likely have an impact on current R&D efforts and concepts surround

The progressive nature of atherosclerotic renal artery stenosis is now well recognized.^1–8 Observational data suggests that untreated renal artery stenosis can lead to progressive hypertension, renal insufficiency, and increased mortality.^6,9–11 The incidence of progressive ischemic nephropathy resulting from atherosclerotic renal artery stenosis had been underestimated in the past. The U.S. Renal Data System annual report in 1999 revealed that up to 20% of new patients > 50 years old requiring hemodialysis have underlying renovascular disease.¹²
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