Renal artery stenting in patients with a solitary functioning kidney.
OBJECTIVE
To retrospectively evaluate the results of renal artery stenting in patients with renovascular disease and a solitary functioning kidney.


METHODS
Palmaz stents were placed in 16 patients with a solitary functioning kidney, renal artery stenosis, hypertension and renal failure. Stenoses were evaluated with color Doppler ultrasound, MR angiography and digital subtraction angiography (DSA). Indications for stenting were: recoil after percutaneous transluminal renal angioplasty (PTRA) (63%), arterial dissection after PTRA (13%) and primary stenting (25%). Immediate results were evaluated by DSA. On follow-up (6-36 months), patients underwent periodical evaluation of clinical conditions (blood pressure and serum creatinine level) and stent patency, by means of color Doppler ultrasound.


RESULTS
Stent placement was successful in all patients (100%). Cumulative primary patency rate was: 100% at 1 day, 93.75% at 6 months, 81.25% at 12 months and 75% at 24 months. A significant reduction in diastolic blood pressure occurred (mean +/- SD 104 +/- 6 vs 92 +/- 3; p < 0.05); renal function improved or stabilized in over 80% of patients. However, there was no significant difference in the creatinine values before and after treatment (mean +/- SD 200 +/- 142 micromol/l vs 197 +/- 182 micromol/l; p > 0.05).


CONCLUSIONS
Renal artery stenting, both after PTRA and as primary stenting, represents a safe procedure, able to preserve renal function in patients with a solitary functioning kidney.
Cioni
R
R
Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, Italy. neri@do.med.unipi.it
Vignali
C
C
Petruzzi
P
P
Neri
E
E
Caramella
D
D
Vagli
P
P
Bargellini
I
I
Napoli
V
V
Pinto
S
S
Bartolozzi
C
C
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D019917:Blood Vessel Prosthesis Implantation; D003404:Creatinine / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000601:surgery*; D012720:Severity of Illness Index; D015607:Stents; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
D003404:Creatinine