Ostial renal artery stent placement in patients 75 years of age or older.
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.
Bloch
M J
MJ
Division of Hypertension, Department of Medicine, New York Presbyterian Hospital/Weill Medical College at Cornell University, New York, USA. mbloch@aol.com
Trost
D A
DA
Whitmer
J
J
Pickering
T G
TG
Sos
T A
TA
August
P
P
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