Figure 9a. PTA of RAS in a 12-year-old girl with a rising serum creatinine level and hypertension. (a) Digital subtraction angiogram shows stenosis of the proximal main renal artery (arrow). Note the superior pole artery anastomosed end-to-side to the external iliac artery. PTA was performed with a 6-mm balloon. (b) Spot view of the anastomosis obtained during PTA shows a guide wire that was passed across the stenosis using an ipsilateral approach. Note the "waist" at the stenosis (arrow). (c) Postangioplasty angiogram shows a patent renal artery without residual stenosis.