title: Preliminary study of the use of drug-eluting stents in atherosclerotic renal artery stenoses 4 mm in diameter or smaller.
abstract: 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.
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, 200 First Street Southwest, Alfred 6460, Rochester, MN 55905, USA. misra.sanjay@mayo.edu
authors.forename: Sanjay
authors.initials: S
authors.lastname: Misra
authors.forename: Mallik R
authors.initials: MR
authors.lastname: Thatipelli
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Howe
authors.forename: Christopher
authors.initials: C
authors.lastname: Hunt
authors.forename: Verghese
authors.initials: V
authors.lastname: Mathew
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
authors.forename: Axel
authors.initials: A
authors.lastname: Pflueger
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Textor
authors.forename: Haraldur
authors.initials: H
authors.lastname: Bjarnason
authors.forename: Michael A
authors.initials: MA
authors.lastname: McKusick
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D019786:Gadolinium DTPA; D017239:Paclitaxel; D020123:Sirolimus