Predictive factors of in-stent restenosis in renal artery stenting: a retrospective analysis.
OBJECTIVE
To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting.


METHODS
From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22+/-12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter.


RESULTS
Comparing group A and B patients (chi(2) test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was >/=6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents).


CONCLUSIONS
Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 15-20 mm.
Vignali
Claudio
C
Department of Oncology, Transplants and Advanced Technologies in Medicine, Division of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56127 Pisa, Italy. cvignali@med.unipi.it
Bargellini
Irene
I
Lazzereschi
Michele
M
Cioni
Roberto
R
Petruzzi
Pasquale
P
Caramella
Davide
D
Pinto
Stefania
S
Napoli
Vinicio
V
Zampa
Virna
V
Bartolozzi
Carlo
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D015901:Angiography, Digital Subtraction; D001161:Arteriosclerosis / Q000145:classification / Q000628:therapy*; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000145:classification / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D015607:Stents; D014280:Triglycerides / Q000097:blood; D018615:Ultrasonography, Doppler, Color
D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine