title: Ostial renal artery stent placement in patients 75 years of age or older.
abstract: Renal artery stent placement has been shown to improve blood pressure (BP) and stabilize renal function in patients with atherosclerotic renovascular disease. However, limited data are available in patients > or = 75 years of age. We analyzed the prestent characteristics and clinical outcomes of patients aged > or = 75 years who underwent renal artery stenting at our institution. We compared these data with those from the remainder of our stent cohort. Nineteen of 89 (21.3%) stent patients were > or = 75 years old. Before intervention, those > or = 75 years were significantly more likely to be women (84.2% v 55%; P = .02), current or former smokers (78.6% v 36.8%; P = .002), and on a greater number of antihypertensive medications (3.68 v 2.80; P = .048). Average clinical follow-up was similar in both groups (23.9 v 23.2 months; P > .05). At last available follow-up, there were more deaths in those > or = 75 years (7/19 v 5/70; P = .038). No significant difference was found in the incidence of dialysis after intervention (3/19 v 7/70). Seventy-four percent of those > or = 75 years had improved BP, 21% were stable, and 5% were worse. Renal function was improved in 26%, stable in 53%, and worse in 21%. Among those > or = 75 years, there was a significant decrease in systolic BP (186.9 to 144.4; P < .01). There was a trend toward decreased diastolic BP and medications. These clinical results did not differ significantly from patients <75 years. Patients > or = 75 years of age with atherosclerotic renovascular disease have a higher incidence of mortality 2 years after renal artery stent placement, but they seem to derive clinical benefit comparable to younger patients.
authors.affiliation: Division of Hypertension, Department of Medicine, New York Presbyterian Hospital/Weill Medical College at Cornell University, New York, USA. mbloch@aol.com
authors.forename: M J
authors.initials: MJ
authors.lastname: Bloch
authors.forename: D A
authors.initials: DA
authors.lastname: Trost
authors.forename: J
authors.initials: J
authors.lastname: Whitmer
authors.forename: T G
authors.initials: TG
authors.lastname: Pickering
authors.forename: T A
authors.initials: TA
authors.lastname: Sos
authors.forename: P
authors.initials: P
authors.lastname: August
mesh_terms: D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D012078:Renal Artery Obstruction / Q000503:physiopathology / Q000628:therapy*; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome