title: Salvage of the solitary kidney by insertion of a renal artery stent.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the use of renal artery stents in the solitary functioning kidney of patients who have impaired renal function as a result of atherosclerotic renovascular disease by assessing primary patency, renal function outcome, and complication rates during a mean follow-up period of 15 months.
  
  
  METHODS
  The Palmaz stent was placed in the arteries of 21 patients with solitary functioning kidneys. All patients had impaired renal function (creatinine level >150 micromol/l), and four patients were undergoing renal dialysis. Indications for stenting were recoil after percutaneous transluminal angioplasty (n = 12), arterial dissection after angioplasty (n = 2), restenosis after angioplasty (n = 1), and as the primary intervention (n = 6). Follow-up angiography was performed in 16 patients (76%).
  
  
  RESULTS
  Initial technical success was achieved in all patients (residual stenosis, <5%). At follow-up (range, 6-25 months), renal function had returned to normal in five patients (24%), improved in four patients (19%), stabilized in six patients (29%), and deteriorated in six patients (29%). Dialysis has been discontinued in all four dialysis patients. Major complications occurred in four patients (19%), including one death within 30 days of stenting. No significant restenoses were seen on follow-up angiography.
  
  
  CONCLUSIONS
  Placement of renal artery stents in the solitary kidney led to benefits in 70% of patients treated, including improved renal function in nine patients (43%) and stabilization in six patients (29%). In this high-risk group of patients, we advocate renal artery stenting as a relatively safe procedure to salvage the solitary kidney.
authors.affiliation: Department of Radiology, Royal Infirmary of Edinburgh, Scotland.
authors.forename: H M
authors.initials: HM
authors.lastname: Shannon
authors.forename: I N
authors.initials: IN
authors.lastname: Gillespie
authors.forename: J G
authors.initials: JG
authors.lastname: Moss
mesh_terms: D001161:Arteriosclerosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006435:Renal Dialysis; D015607:Stents; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome