[Early results with a monorail-stent-balloon device for endovascular treatment of renal artery stenosis].
OBJECTIVE
To evaluate the technical feasibility of a new monorail-stent-balloon device for treatment of renal artery stenosis (RAS).


METHODS
During a study period of 18 months, 38 patients with proven RAS in 41 cases (hypertension n = 36, renal insufficiency n = 13) and indication for stenting (calicified ostial lesions n = 35, insufficient PTA n = 4, dissection n = 2) were enrolled into this prospective evaluation. Pre-mounted stents (Rx-Herculink(TM) 5 mm = 13, 6 mm = 34, 7 mm = 1) were implanted a transfemoral (n = 35) or transbrachial approach (n = 6). Mean grade and lengths of stenosis measured were 88 % plus minus 10 and 9 mm plus minus 5.


RESULTS
Renal stent implantation was technically successful in all cases (100 %). In 7 cases a second stent had to be implanted to cover the entire lesion. The transstenotic pressure drop decreased from 88 mmHg plus minus 10 before to 1 mmHg plus minus 1.8 after the procedure. Remaining stenosis measured 0.7 % plus minus 4.2. Serum creatine levels decreased from 1.9 mm/dl to 1.5 mg/dl (n. s.), blood pressure decreased from 178/94 mmHg to 148/79 mmHg (p < 0.0001) after the intervention. Primary and secondary patency rates at 6 months were 72 % (Standard Error 9.8 %) and 77 (% (Standard Error 9.2 %), respectively.


CONCLUSIONS
With the used monorail-stend-balloon device a technically easy, secure and exact renal stent placement is guaranteed, patency rates are similar to those described in the current literature.
Müller-Hülsbeck
S
S
Universitätsklinikum Kiel, Klinik für Diagnostische Radiologie, Christian-Albrechts-Universität zu Kiel, Germany. muehue@rad.uni-kiel.de
Jahnke
T
T
Grimm
J
J
Behm
C
C
Hilbert
C
C
Frahm
C
C
Biederer
J
J
Brossmann
J
J
Heller
M
M
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents