title: Embolic protection devices in patients with renal artery stenosis with chronic renal insufficiency: a clinical study.
abstract: OBJECTIVE
  To present clinical outcomes with the use of embolic protection devices (EPDs) and renal artery stents in patients with chronic renal insufficiency (CRI) and renal artery stenosis (RAS).
  
  
  METHODS
  A retrospective study was conducted in 23 patients with RAS and CRI who were treated with renal artery stent placement with an EPD. Follow-up data were obtained through medical records.
  
  
  RESULTS
  In 23 patients (18 men; 78%) with an average age of 69.4 years +/- 11 (range, 46-86 y), 32 renal arteries were treated for worsening renal function (n = 17; 74%) or uncontrolled hypertension and worsening renal function (n = 6; 26%). Nine FilterWire EZ devices were used in eight patients (35%) and 17 SpideRX devices were used in 15 patients (65%). The average follow-up was 8 months +/- 5. After the stent procedure, the mean systolic blood pressure decreased significantly (P < .05) whereas the diastolic pressure remained unchanged. There was a significant increase in the mean estimated glomerular filtration rate from 32.9 mL/min +/- 12.9 at baseline to 41.3 mL/min +/- 13.7 at last follow-up (P < .05). In 96% of patients, there was improvement or stabilization of kidney function. In six of the 17 SpideRX devices (35%), macroscopically evident embolic material was observed in the device after stent placement. There were two minor and two major complications.
  
  
  CONCLUSIONS
  Renal artery stent placement combined with the use of a SpideRX or FilterWire EZ device is associated with an good clinical outcome with a reasonable safety profile.
authors.affiliation: Department of Radiology, Mayo Clinic College of Medicine, 200 First Street Southwest, Alfred 6460, Rochester, MN 55902, USA. misra.sanjay@mayo.edu
authors.forename: Sanjay
authors.initials: S
authors.lastname: Misra
authors.forename: Manuel T
authors.initials: MT
authors.lastname: Gomes
authors.forename: Verghese
authors.initials: V
authors.lastname: Mathew
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Barsness
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; D001807:Blood Vessel Prosthesis; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome