Midterm results of renal artery stenting

Abstract

Percutaneous transluminal angioplasty (PTA) has become the treatment of choice for major renal artery stenosis. Nonetheless, about 10% of renal artery stenoses cannot be properly dilated, and among the patients successfully dilated, 10%-15% had a recurrence. Renal artery stenting was used in 21 patients in cases of insufficient results after PTA: persisting significant stenosis after a primary or several PTAs (15 cases), recurrences (9 cases). Follow-up in all patients was from 12 months to 4 years. Implantation was performed without any problems but the low radioopacity of the stent makes placement difficult in obese patients, particularly for ostial lesions. There was no major complication except occlusion of a segmental branch of the renal artery in 1 case. Radiological controls have shown a preserved patency in all cases except 2, which present restenosis inside the stent by intimal hyperplasia. A significant clinical improvement was obtained in 90% of cases. These results suggest that the endovascular prosthesis represents an important adjunct to renal PTA.

Effect of gender on outcomes following renal artery stent placement for renovascular hypertension

“…In studies utilizing balloon expandable stents after inadequate results following percutaneous renal angioplasty for atherosclerotic renovascular disease, cure or improvement of hypertension has been reported in 64-100% of patients at a mean follow-up of 6-32.3 mo, and the restenosis rate has varied from 10-39% at a mean follow-up of 6.4-29 mo [16][17][18][19][20][21]. Our results following stent implantation for renal artery stenosis and resistant hypertension are comparable with these numbers.…”

“…Our results following stent implantation for renal artery stenosis and resistant hypertension are comparable with these numbers. Previous reports on renal artery stent implantation [16][17][18][19][20][21][22] have not addressed the effect of gender on outcomes. Our study shows no difference in the technical success rate, incidence of complications, acute, 6-mo, or long-term blood-pressure response, or incidence of restenosis between male and female patients undergoing stent place-ment for renal artery stenosis and refractory hypertension.…”

The role of percutaneous revascularization for renal artery stenosis

“…[133][134][135] Case series of patients with atherosclerotic RAS report cure of HTN in less than 10% (range 0-19%) and improvement in 53% (range 42-63%). 6,106,110,113,115,116,118,[136][137][138][139][140] Results of surgical series are similar, albeit with higher complication rates and higher costs. 92,141,142 Multiple parameters (clinical, biochemical, radiological, anatomical) have been evaluated for their utility in predicting which patients are most likely to benefit from RAI in terms of blood pressure control.…”

Long-Term Results of Percutaneous Transluminal Angioplasty in Renovascular Hypertension

“…Intravascular stenting may improve results in ostial stenosis, and in fibromuscular lesions with a marked elastic component (5). Significant restenosis caused by neo-intimal lesions after stenting, however, remains a major challenge.…”