Clinical efficacy of percutaneous renal revascularization with stent placement in atherosclerotic renovascular disease.
OBJECTIVE
To evaluate the clinical efficacy of percutaneous renal revascularization with stenting to control hypertension and preserve/restore renal function in patients with atherosclerotic renovascular disease.


METHODS
From May/1999 to October/2003, 46 patients with atherosclerotic renal artery stenosis (ARAS) underwent revascularization with stenting. The indication for the procedure was hypertension control and/or renal function preservation/restoration. Clinical characteristics: age range: 33-84 years (median = 58.5 +/-10.7), males: 26 (56.5%), 4 (10%) patients with diabetes mellitus, 21 (46%) patients with coronary artery disease, creatinine <2.0mg/dl: 39 (64%), 6 patients (14%) with congestive heart failure, 20 (43%) patients with ostial stenosis and 15 (33%) patients with bilateral stenosis. Hypertension control was evaluated by the number of drugs used before the procedure and at follow-up (FU) and by blood pressure (BP) measurement.


RESULTS
The minimum follow-up was 7 months (range of 7-52, median: 23, mean: 24.2 +/- 15.2). There were no major complications. No patient experience any cardiovascular event. There was only one non-cadiac death (2%) and one technical failure in the treatment(2%). There was no serious complication in the procedure. None of the patients presented cardiovascular events. The renal function improved or stabilized in 32 patients (82%) and worsened in 4 (10%). The BP control improved in 19/44 (43,8%) patients and worsened / stabilized in 6 patients (14%).


CONCLUSIONS
Angioplasty with renal artery stenting for ARAS showed to be an effective treatment strategy to restore and preserve renal function and to control blood pressure.
Gonçalves
Janaína Andréa Altemar
JA
Hospital do Rim e Hipertensão, Fundação Oswaldo Ramos, São Paulo, SP, Brazil. jan_goncalves@uol.com.br
Amorim
Jorge Eduardo
JE
Soares Neto
Milton Macedo
MM
Ribeiro
Artur Beltrame
AB
Lima
Valter Correa
VC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D050197:Atherosclerosis / Q000150:complications / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000209:etiology / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome