Introduction: As population grows old, so does the incidence and prevalence of atherosclerosis, which can also be incriminated as a frequent cause of renal artery stenosis, a pathology many times overlooked. The renal artery stenosis is accompanied by many consequences, among which stands the severe hypertension, very di-fficult to treat.

Methods: We present the case of a 64-year-old pati-ent, smoker, diabetic (insulin- required), hypertensive, who presents severe tension values in ambulatory mo-nitoring (maxim systolic blood pressure=250mmHg), refractory to anterior treatment, with symptoms as occipital headache and dizziness when standing.The clinically and paraclinically exams (including the renal arteries arteriography) have established the bilateral renal artery stenosis with grade IV renal failure. It is taken into consideration the opportunity of renal ar-tery revascularisation with a more adequate treatment in conjunction with his new clinical status.

Results: After the highlight of his renal viability throu-gh renal scintigraphy, the unilateral stenting of the ri-ght renal artery is decided. Furthermore, is presented the post-procedural clinical, biological and tensional profile of the patient.

Conclusions: In conclusion the renal artery stenosis hypertension is a severe and hard-to-treat pathology, both medical and interventional. The interventional revascularisation has limited indications and benefits.