Results of renal artery balloon angioplasty limit its indications

Abstract

Percutaneous transluminal balloon angioplasty (PTA) of 83 renal artery lesions in 55 patients was done because of renal failure in eight patients, hypertension in 35, renal failure and hypertension in 11, and polycythemia in one patient. Early results in 38 patients with arteriosclerosis showed five (13%) were worse and 13 (34%) were unchanged. Twenty patients (53%) with arteriosclerosis were initially cured or improved; however, seven of these patients had recurrence in 4 to 48 months. Ultimately, only 13 of 38 patients with arteriosclerosis (34%) were cured or improved (mean follow-up 22 months). Nine patients with fibromuscular dysplasia required 17 dilatations of arteries (three bilateral and five repeat), resulting in eight patients (89%) who were cured or improved. Selection of patients with hypertension by medical failure while receiving three or more hypertension medications or by lateralizing renal vein renin values yielded benefit in 17 of 26 patients (65%). Five of six patients with transplant stenosis of the renal artery and hypertension were cured or improved at mean follow-up of 18 months. Overall technical results of 83 artery dilatations were as follows: good, 58 (69%); fair, 10 (12%); poor or unsatisfactory, 16 (19%); these were judged with a blinded radiologic review. No patient suffered main renal artery thrombosis. There were 16 patients with complications of dilatation (morbidity rate of 29%). Nine patients subsequently had renal artery surgery from the same day to 64 days later with good results in all patients except one.(ABSTRACT TRUNCATED AT 250 WORDS)

C-Type Natriuretic Peptide Inhibits Constrictive Remodeling Without Compromising Re-Endothelialization in Balloon-Dilated Renal Arteries

“…This difference in the mechanism of restenosis may be explained by developmental variations between one arterial bed and another. Coronary and femoral arteries derive from mesoderm, 24 while renal arteries derive from endoderm, 25 so it is not surprising that the pathogenesis of restenosis varies according to vessel anatomy. 24,26 Consequently, therapeutic measures may have varying effects in different sections of the arterial tree, which requires their evaluation in the artery of interest.…”

Percutaneous Transluminal Angioplasty of Renal Artery Fibromuscular Dysplasia: Mid-term Results

“…Recently, percutaneous transluminal renal artery angioplasty (PTRA), with or without stent placement, has become the preferred choice for correcting symptomatic renal FMD as it is less invasive than surgical reconstruction (7, 8). …”

Four-Year Follow-up of Palmaz-Schatz Stent Revascularization as Treatment for Atherosclerotic Renal Artery Stenosis

“…[1][2][3][4][5][6][7][8] Although surgical revascularization has cured or improved blood pressure control, preserved or stabilized renal function, 9 -15 and reversed end-stage renal failure, 16 -18 its morbidity and mortality rates have been higher than those of stent revascularization. 19 -24 Stent revascularization has created the perception of superiority to balloon angioplasty [25][26][27][28][29][30][31] and surgical revascularization, but the paucity of stent publications precludes even historical comparison with surgical data. This article details the 4-year follow-up of 145 patients Ն6 months after their procedures who underwent PalmazSchatz stent revascularization of Ն1 stenotic renal artery, as well as its impact on renal function, blood pressure control, and survival.…”