Efficiency of Percutaneous Stent Angioplasty in Renal Artery Stenosis - 15 Years of Experience at a Single Center.

Abstract

PURPOSE:

 To determine the therapeutic efficiency of percutaneous revascularization in renal artery stenosis (RAS), as well as the role of comprehensive factors such as patient selection and degree of artery stenosis, on clinical outcome.

METHODS AND MATERIALS:

 101 patients with hemodynamically relevant RAS underwent percutaneous angioplasty (PTA). 65.7 % were male (mean age: 64 years; range: 18-84). The clinical data was retrospectively analyzed. The serum creatinine (Cr), glomerular filtration rate (GFR), and blood pressure (BP) levels pre- and postprocedural, between 6 months and 1 year, were retrospectively collected and statistically analyzed.

RESULTS:

 Follow-up data was available in 34 (33.7 %) and 28 patients (27.7 %) for Cr and MAP, respectively. A significant drop in mean arterial pressure (MAP) was observed on follow-up (mean -5.27 mmHg). Higher baseline Cr and MAP values showed a more pronounced drop in the follow-up (Cr: p 0.002; difference to baseline -0.25 mg/dL, 95 %CI:-0.36, -0.07 and BP p < 0.001; diff. to baseline -0.72 mmHg; 95 %CI: -1.4, -0.40). There was no association between comorbidities, gender, and degree of stenosis with renal and BP outcome. No significant improvement in renal function was observed on follow-up (mean Cr drop: -0.015 mg/dL). The age group 51-60 years showed a significant improvement in BP (p 0.030; diff. to baseline -19.2 mmHg; 95 %CI: -34, -4.3). There was a slight reduction in antihypertensive medication following angioplasty (0.2 fewer). Minor complications were recorded in five procedures (4.9 %).

CONCLUSION:

 Percutaneous renal artery revascularization in the presence of atherosclerotic RAS is a safe procedure associated with a significant drop in post-procedural BP. No significant improvement in renal function was observed. Further prospective studies focused on patient selection are necessary.

KEY POINTS:

  · Percutaneous stent angioplasty in renal artery stenosis is associated with a significant improvement in post-procedural blood pressure control.. · There is no improvement in renal function after percutaneous stent angioplasty for renal artery stenosis (RAS).. · Percutaneous stent angioplasty is a safe procedure..

CITATION FORMAT:

· Guerreiro H, Avanesov M, Dinnies S et al. Efficiency of Percutaneous Stent Angioplasty in Renal Artery Stenosis - 15 Years of Experience at a Single Center. Fortschr Röntgenstr 2021; 193: 298 - 304.

• Authors: Helena Guerreiro, Maxim Avanesov, Stefanie Dinnies, Susanne Sehner, Gerhard Schön, Ulrich Wenzel, Gerhard Adam, Harald Ittrich, Marc Regier
• Journal: RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin (Rofo) Vol. 193 Issue 3 Pg. 298-304 (Mar 2021) ISSN: 1438-9010 [Electronic] Germany
• Vernacular Title: Effizienz der perkutanen Stentangioplastie bei Nierenarterienstenose – die 15-jährige Erfahrung eines Einzelzentrums.
• PMID: 33003245 (Publication Type: Journal Article)
• Copyright: Thieme. All rights reserved.

Topics

• Adult
• Aged
• Angioplasty (standards)
• Female
• Humans
• Male
• Middle Aged
• Renal Artery Obstruction (diagnostic imaging, surgery)
• Retrospective Studies
• Stents (standards)
• Treatment Outcome