Stent placement for renal arterial stenosis: where do we stand? A meta-analysis.
OBJECTIVE
To perform a meta-analysis of renal arterial stent placement in comparison with renal percutaneous transluminal angioplasty (PTA) in patients with renal arterial stenosis.


METHODS
Studies dealing with renal arterial stent placement (14 articles; 678 patients) and renal PTA (10 articles; 644 patients) published up to August 1998 were selected. A random-effects model was used to pool the data.


RESULTS
Renal arterial stent placement proved highly successful, with an initial adequate performance in 98% and major complications in 11%. The overall cure rate for hypertension was 20%, whereas hypertension was improved in 49%. Renal function improved in 30% and stabilized in 38% of patients. The restenosis rate at follow-up of 6-29 months was 17%. Stent placement had a higher technical success rate and a lower restenosis rate than did renal PTA (98% vs 77% and 17% vs 26%, respectively; P <.001). The complication rate was not different between the two treatments. The cure rate for hypertension was higher and the improvement rate for renal function was lower after stent placement than after renal PTA (20% vs 10% and 30% vs 38%, respectively; P <.001).


CONCLUSIONS
Renal arterial stent placement is technically superior and clinically comparable to renal PTA alone.
Leertouwer
T C
TC
Department of Radiology, Erasmus University Rotterdam (Ee 2312), The Netherlands. leertouwer@tch.fgg.eur.nl
Gussenhoven
E J
EJ
Bosch
J L
JL
van Jaarsveld
B C
BC
van Dijk
L C
LC
Deinum
J
J
Man In 't Veld
A J
AJ
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy*; D015607:Stents / Q000009:adverse effects