title: Renal artery PTA and stent implantation: immediate and late clinical and morphological outcome.
abstract: BACKGROUND
  Renal artery stenosis (RAS) is a potentially curable cause of secondary hypertension, but the indications for interventional treatment of renovascular hypertension are still a matter of debate. The aim of the study was to investigate immediate and long-term results of percutaneous renal artery revascularization (PTRA). Primary technical success, peri-intervention complications, patency, the course of arterial hypertension and renal function were analyzed.
  
  
  METHODS
  32 renal interventions in 24 consecutive patients (15 PTA, 17 stents) were investigated in a retrospective cohort study. Comorbidities, interventional data and serum creatinine were recorded. Patients were followed for a median period of 45 months (IQR, 32 to 68). Clinical evaluation of the course of blood pressure, serum creatinine, Doppler ultrasound evaluation and multi-slice spiral-CT angiography were performed at follow-up.
  
  
  RESULTS
  Primary technical success was achieved in 30 interventions (94%), and in 2 patients during a secondary intervention. The rate of complications was 16% (n = 5). Three major complications were encountered (9%): 1 renal artery thrombosis and 2 acute renal failures. Three patients developed late renal failure after 1, 4 and 37 months, but the overall serum creatinine levels remained stable during the observation period. Hypertension was improved after intervention in 17 patients (71%). However, recurrent hypertension was found in 9 patients (38%) after a median period of 49 months (IQR, 47 to 96). Patency rates at 12, 24 and 72 months were 94%, 94% and 64%, respectively.
  
  
  CONCLUSIONS
  Renal artery PTA can be performed with an acceptable rate of major complications and good long term morphological results. However, clinical outcome in terms of sustained improvement of hypertension is moderate.
authors.affiliation: Department of Angiology, Vienna General Hospital, Medical Faculty, Vienna, Austria.
authors.forename: Ramazanali
authors.initials: R
authors.lastname: Ahmadi
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Schila
authors.initials: S
authors.lastname: Sabeti
authors.forename: Christian
authors.initials: C
authors.lastname: Loewe
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Markus
authors.initials: M
authors.lastname: Haumer
authors.forename: Martin
authors.initials: M
authors.lastname: Banyai
authors.forename: Johannes
authors.initials: J
authors.lastname: Lammer
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
mesh_terms: D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000628:therapy*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000628:therapy*; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome