Abstract
We present the case of a 46-year-old man with bilateral renal artery stenosis and a previous stent placed on the left renal artery who presented with a hypertensive emergency with flash pulmonary edema and acute-on-chronic renal failure. A renal angiogram revealed extensive thrombosis and in-stent restenosis, which were treated with thrombectomy, angioplasty, and stenting. Our case highlights the importance of careful patient selection for renal artery stenting and close monitoring post-stenting due to the risk of serious complications.