Renal artery stenting in solitary functioning kidneys: Technical and clinical results

Şahin, Sinan; Çimşit, Çağatay; Andaç, Nurten; Baltacıoğlu, Feyyaz; Akoğlu, Emel

doi:10.1016/j.ejrad.2005.05.004

Cited by 11 publications

(14 citation statements)

References 34 publications

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“…Patients with continued progression despite technically successful revascularization commonly reach end-stage renal disease (ESRD). In nearly all reported series, a subset of patients progresses to advanced renal failure despite technically successful stenting [90]. …”

Section: Present: Endovascular Restoration Of Renal Blood Flowmentioning

confidence: 99%

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Textor

Misra

Oderich

2013

Kidney International

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Occlusion of the renal arteries can threaten the viability of the kidney when severe, in addition to accelerating hypertension and circulatory congestion. Renal artery stenting procedures have evolved from a treatment mainly for renovascular hypertension to a maneuver capable of recovering threatened renal function in patients with “ischemic nephropathy” and improving management of congestive heart failure. Improved catheter design and techniques have reduced, but not eliminated hazards associated with renovascular stenting. Expanded use of endovascular stent grafts to treat abdominal aortic aneurysms has introduced a new indication for renal artery stenting to protect the renal circulation when grafts cross the origins of the renal arteries. Although controversial, prospective randomized trials to evaluate the added benefit of revascularization to current medical therapy for atherosclerotic renal artery stenosis until now have failed to identify major benefits regarding either renal function or blood pressure control. These studies have been limited by selection bias and have been harshly criticized. While studies of tissue oxygenation using blood oxygen level dependent (BOLD) MR establish that kidneys can adapt to reduced blood flow to some degree, more severe occlusive disease leads to cortical hypoxia associated with microvascular rarefication, inflammatory injury and fibrosis. Current research is directed toward identifying pathways of irreversible kidney injury due to vascular occlusion and to increase the potential for renal repair after restoring renal artery patency. The role of nephrologists likely will focus upon recognizing the limits of renal adaptation to vascular disease and identifying kidneys truly at risk for ischemic injury at a time point when renal revascularization can still be of benefit to recovering kidney function.

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Section: Present: Endovascular Restoration Of Renal Blood Flowmentioning

confidence: 99%

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Textor

Misra

Oderich

2013

Kidney International

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“…Other reports have shown mortality rates ranging from 0% to 4% and all-cause morbidity rates ranging from 27% to 43%. [25][26][27] These data compared very favorably to open surgery where perioperative mortality was 6%, and major morbidity was 43%, including the need for permanent (9%) and temporary (9%) dialysis. 28 It thus appears that intervention in the solitary kidney has a relatively low mortality and morbidity compared to historical data on endoluminal intervention and open surgery.…”

Section: Discussionmentioning

confidence: 68%

“…Cumulative patency rates in this series determined by serial duplex scan imaging were 81 Ϯ 5% vs 87 Ϯ 6% at 5 years and 68% vs 83% at 10 years for normal and solitary kidney groups. In a series of 15 patients by Sahin et al, 25 primary patency rates were 100% for 6 months, 92.3% for 12 months, and 69.2% for 24 months. The secondary patency rate at 24 months was 100%.…”

Section: Discussionmentioning

confidence: 95%

Endovascular revascularization of renal artery stenosis in the solitary functioning kidney

Saad

Bismuth²,

Naoum

et al. 2009

Journal of Vascular Surgery

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“…[5][6][7][8][9][10] Although PTRAS was shown to improve or stabilize renal function in the majority of the patients, it was also associated with renal function deterioration in 13-38% of the cases. Based on the hypothesis that this phenomenon may be partly or totally due to distal atheroembolization during the procedure, we investigated the use of distal embolic protection (DEP) devices in patients undergoing primary stenting of the renal artery for solitary kidney salvage.…”

mentioning

confidence: 86%

“…An increase of 20% or more from baseline level was classified as deterioration in renal function and creatinine values within 20% of baseline were considered to be unchanged. 5,8 Renal function cure was defined as serum creatinine Յ1.4 mg/dL after the procedure.…”

Section: Patientsmentioning

confidence: 99%

Efficacy of protected renal artery primary stenting in the solitary functioning kidney

Klonaris¹,

Katsargyris²,

Alexandrou³

et al. 2008

Journal of Vascular Surgery

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Renal artery stenting in solitary functioning kidneys: Technical and clinical results

Cited by 11 publications

References 34 publications

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Percutaneous revascularization for ischemic nephropathy: the past, present, and future

Endovascular revascularization of renal artery stenosis in the solitary functioning kidney

Efficacy of protected renal artery primary stenting in the solitary functioning kidney

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