1999

DOI: 10.1016/s0140-6736(98)04432-8

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Arterial stenting and balloon angioplasty in ostial atherosclerotic renovascular disease: a randomised trial

Peter Jg van de Ven¹,

R. S. J. P. Kaatee²,

Jaap J. Beutler³

et al.

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Ptra: Effects On Blood Pressure1

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Cited by 533 publications

(260 citation statements)

References 29 publications

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“…17,18,[19][20][21][22][23] Therefore, we performed stent implantation in all of our cases. The clinical merits and cost-efficacy of this strategy are supported by Van De Ven, et al 24) Renal intervention has been reported to be effective in blood pressure control. 25) In the present study, medication was abandoned or reduced in 85% of the cases.…”

Section: Discussionmentioning

confidence: 94%

<b>Effect of Renal Artery Stenting on Renal Function in Patients With Ischemic Nephropathy</b>

et al. 2004

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SUMMARYThe aim of this study was to evaluate the effects of stenting on blood pressure and renal functions in azotemic patients with proximal/ostial atherosclerotic renal artery stenosis.Thirteen azotemic patients (5 females, 8 males, average age, 62.7 ± 8.3 years) who had renal artery stenosis were included in the study. Their blood pressure, estimated glomerular filtration rate (EGFR), and creatinine levels were measured at baseline and during follow-up.Stents were implanted successfully in all of the cases. The average stent diameter and stent length were 7.2 ± 0.5 mm and 17.2 ± 3.4 mm, respectively. Antihypertensive drug was abandoned in 1 (7.6%) patient, reduced in 10 patients (76.9%), and not changed in 2 (15.3%) patients. Significant improvement was observed in the mean serum creatinine level at the 12 th month when compared with baseline (2.56 ± 0.88; 1.83 ± 0.62, P < 0.001). EGFR was 18.38 ± 4.64 before the procedure and 22.67 ± 3.81 during follow-up (P < 0.0001). According to the EGFR criteria, renal function was determined to be worse in 1 (7.6%) patient, stabilized in 2 (15.3%), and improved in 10 (76.9%) patients. One patient died during the follow-up period. Angiographic restenosis was observed in 2 (15.3%) patients. Follow-up major events were observed in 3 (23%) patients.Stenting azotemic patients with renal artery stenosis is a reliable and effective procedure for achieving an improvement in renal function. (Jpn Heart J 2004; 45: 637-645)

“…17,18,[19][20][21][22][23] Therefore, we performed stent implantation in all of our cases. The clinical merits and cost-efficacy of this strategy are supported by Van De Ven, et al 24) Renal intervention has been reported to be effective in blood pressure control. 25) In the present study, medication was abandoned or reduced in 85% of the cases.…”

Section: Discussionmentioning

confidence: 94%

<b>Effect of Renal Artery Stenting on Renal Function in Patients With Ischemic Nephropathy</b>

et al. 2004

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SUMMARYThe aim of this study was to evaluate the effects of stenting on blood pressure and renal functions in azotemic patients with proximal/ostial atherosclerotic renal artery stenosis.Thirteen azotemic patients (5 females, 8 males, average age, 62.7 ± 8.3 years) who had renal artery stenosis were included in the study. Their blood pressure, estimated glomerular filtration rate (EGFR), and creatinine levels were measured at baseline and during follow-up.Stents were implanted successfully in all of the cases. The average stent diameter and stent length were 7.2 ± 0.5 mm and 17.2 ± 3.4 mm, respectively. Antihypertensive drug was abandoned in 1 (7.6%) patient, reduced in 10 patients (76.9%), and not changed in 2 (15.3%) patients. Significant improvement was observed in the mean serum creatinine level at the 12 th month when compared with baseline (2.56 ± 0.88; 1.83 ± 0.62, P < 0.001). EGFR was 18.38 ± 4.64 before the procedure and 22.67 ± 3.81 during follow-up (P < 0.0001). According to the EGFR criteria, renal function was determined to be worse in 1 (7.6%) patient, stabilized in 2 (15.3%), and improved in 10 (76.9%) patients. One patient died during the follow-up period. Angiographic restenosis was observed in 2 (15.3%) patients. Follow-up major events were observed in 3 (23%) patients.Stenting azotemic patients with renal artery stenosis is a reliable and effective procedure for achieving an improvement in renal function. (Jpn Heart J 2004; 45: 637-645)

“…However, femoral artery complications, such as the necessity of access-site vascular repair or blood transfusion, were reported to occur in 2-6% of patients undergoing coronary and renal angioplasty. 7,11,13) In addition, Kiemeneij, et al documented that femoral and brachial artery accesses have similar complication rates. 7) In contrast, the transradial access is widely accepted in coronary angiography and intervention, because of its reduced vascular complications.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, from recent reports, it has been clarified that primary renal stent placement is superior to renal balloon angioplasty alone in view of the angiographic results, the functional results, and vessel patency, particularly in ostial lesions characterized by a high restenosis rate. [11][12][13] Precise implantation of the stent is considered to be critical to minimize the chances of restenosis. Optimally, 1-2 mm of the stent should protrude into the abdominal aorta to suppress invasion of aortic atherosclerotic plaque over the ostium of the renal artery.…”

Section: Discussionmentioning

confidence: 99%

Transradial Renal Artery Angioplasty and Stenting in a Patient With Leriche Syndrome

et al. 2005

Int. Heart J.

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SUMMARYPercutaneous interventional procedures in the renal arteries are usually performed employing a femoral or brachial vascular access. In contrast, the transradial approach has been established for coronary angiography and angioplasty. We encountered a patient with Leriche syndrome who had renovascular hypertension ascribed to a severe left renal artery stenosis. To stabilize his blood pressure, we made an attempt to relieve the renal artery stenosis with Leriche syndrome by transradial renal artery angioplasty and stenting, using devices for coronary intervention. The procedure was successful without complications or residual stenosis. His hypertension improved with less antihypertensive medications. This case suggests that the radial approach might become an alternative entry site for renal artery interventions. (Int Heart J 2005; 46: 557-562)

“…In a trial comparing PTRA plus stenting (PTRAS) to PTRA alone [28], PTRAS seemed to be a better technique than PTRA to achieve vessel patency in ostial ARAS. However, the two procedures did not differ in their effects on blood pressure outcome after 6 months of follow-up.…”

Section: Ptra: Effects On Blood Pressurementioning

confidence: 99%

Atherosclerotic renovascular disease and renal impairment: Can we predict the effect of intervention?

Mui¹,

³

2007

Current Science Inc

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Atherosclerotic renal artery stenosis (ARAS) is associated with hypertension, ischemic nephropathy, and high cardiovascular risk. We review the data on revascularization of the renal artery by percutaneous transluminal renal angioplasty (PTRA) and pharmacological therapy. In patients with severe ARAS and poorly controlled hypertension, PTRA can improve blood pressure control. In patients with rapid renal function loss and severe ARAS, PTRA can improve short-term renal function, but there is no evidence for long-term renoprotection. Recent evidence indicates that ARAS, and incidental renal artery stenosis, considerably increases cardiovascular risk, independent of blood pressure, renal function, and prevalent risk factors. This suggests that revascularization might potentially improve overall prognosis, but no data are available currently. The high cardiovascular risk warrants aggressive pharmacological treatment to prevent progression of the generalized vascular disorder. Ongoing trials will show whether revascularization has added, long-term effects on blood pressure, renal function, and cardiovascular prognosis.

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