Long-term follow-up after renal artery stenting.
BACKGROUND
Renal artery stenosis may cause secondary arterial hypertension and lead to end-stage renal disease. Percutaneous transluminal angioplasty with stent implantation (PTRAS) allows effective and consistent treatment with a high technical success rate. The present trial focuses on the morphological and clinical results as assessed at a long-term follow-up (FU) visit. The main goals were assessment of the restenosis rate and evaluation of arterial hypertension and renal function.


METHODS
40 patients who had undergone successful stenting of a main renal artery were prospectively enrolled. At the FU visit, all patients underwent a risk-factor assessment, evaluation of arterial blood pressure and serum creatinine, and multi-detector computed tomography angiography (CTA).


RESULTS
Median FU was 3.3 years. Hyperlipidemia was present in 67.5% of the patients, current cigarette smoking in 35% and diabetes mellitus in 15%. All patients still suffered from arterial hypertension but, compared with the pre-interventional situation, arterial hypertension was improved in 37.5%. Serum creatinine was increased in 25% of patients, mean creatinine level was 1.3 +/- 0.4 mg/dl. Hemodynamically relevant restenosis was detected by observer 1 in five patients and by observer 2 in six patients, giving restenosis rates of 12.5% and 15%, respectively, after the median FU period. Both observers detected three additional relevant stenoses in the contralateral main renal arteries.


CONCLUSIONS
PTRAS gives excellent morphological long-term results. However, the clinical long-term outcome regarding arterial hypertension and renal function is only moderate.
Bucek
Robert A
RA
Department of Angiography and Interventional Radiology, University Clinic for Radiology, Vienna General Hospital, Vienna, Austria. robert.bucek@akh-wien.ac.at
Puchner
Stefan
S
Reiter
Markus
M
Dirisamer
Albert
A
Minar
Erich
E
Lammer
Johannes
J
D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon; D015992:Body Mass Index; D015331:Cohort Studies; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000628:therapy*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome