Preliminary study of the use of drug-eluting stents in atherosclerotic renal artery stenoses 4 mm in diameter or smaller.
OBJECTIVE
To describe restenosis and clinical outcomes with drug-eluting stents (DESs) and compare them to those of bare metal stents (BMSs) in the treatment of symptomatic atherosclerotic renal artery stenosis (RAS) in the same patients.


METHODS
A retrospective study was performed of all patients with RAS treated with a DES (Taxus Express 2 or Cypher). DESs were used for RASs with luminal vessel diameters of 4 mm or smaller and BMSs were used for those larger than 4 mm.


RESULTS
Sixteen patients (eight women; mean age, 72 years +/- 8) underwent treatment of 27 RASs for worsening renal function (n = 10) and uncontrolled hypertension (n = 6). Eighteen RASs were treated with 23 DESs (Cypher, n = 12; Taxus, n = 11) and nine were treated with BMSs. The average follow-up was 22 months +/- 10. After the procedure, the mean systolic blood pressure decreased significantly (P < .05), with no change in the mean diastolic pressure, serum creatinine, or number of antihypertensive medications. By Kaplan-Meier estimates, the 1- and 2-year patency rates for DESs were 78% and 68%, respectively; and for BMSs, the respective rates were 58% and 47% (P = NS). The average diameters of RASs were 3.4 mm +/- 0.6 in the DES group and 5.3 mm +/- 0.6 in the BMS group (P < .05). There were two technical failures (7.7%) in the DES group. There was one minor complication and a non-flow-limiting dissection.


CONCLUSIONS
DESs were used to treat RASs with good technical results and low restenosis rates compared with BMSs despite the smaller artery diameters in the DES group.
Misra
Sanjay
S
Department of Radiology, Mayo Clinic College of Medicine, 200 First Street Southwest, Alfred 6460, Rochester, MN 55905, USA. misra.sanjay@mayo.edu
Thatipelli
Mallik R
MR
Howe
Patrick W
PW
Hunt
Christopher
C
Mathew
Verghese
V
Barsness
Gregory W
GW
Pflueger
Axel
A
Textor
Stephen C
SC
Bjarnason
Haraldur
H
McKusick
Michael A
MA
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D054855:Drug-Eluting Stents; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000188:drug therapy*; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*; D014463:Ultrasonography; D014655:Vascular Resistance
D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D019786:Gadolinium DTPA; D017239:Paclitaxel; D020123:Sirolimus