Improved renal function and blood pressure control following renal artery angioplasty: the renal artery angioplasty in patients with renal insufficiency and hypertension using a dedicated renal stent device study (PRECISION).
OBJECTIVE
To evaluate the technical performance of a dedicated renal stent device and the clinical outcome.


RESULTS
Fifty patients with 55 renal artery stenoses (RAS) >70% (66 +/- 12 years, 58% male) were included in this non-randomised, prospective, multicentre registry. Primary endpoint was the primary patency rate at one year defined as > or =70% as determined by duplex ultrasound. Major secondary endpoints were procedural success, 30 days MACE rate, the impact of the intervention on renal function, blood pressure control, and on B-type natriuretic peptide (BNP) level. Procedural success rate was 100% and 30 days MACE rate was 0%. Restenosis rate (primary endpoint) and target lesion revascularisation rate after 12 months were 3.5% and 1.8%, respectively. After one year estimated glomerular filtration rate increased from 51 +/- 26 ml/min to 61 +/- 28 ml/min (P=0.004). Mean ambulatory blood pressure was reduced from 102 +/- 14 mmHg to 93 +/- 9 mmHg (P=0.001). Mean daily dose of antihypertensive drugs decreased from 3.0 +/- 1.7 to 2.7 +/- 1.4 (P=0.09). Mean BNP decreased from 251 +/- 282 pg/ml to 188 +/- 219 pg/ml (P=0.046) before discharge.


CONCLUSIONS
Technical outcome of the tested device is favourable. The impact of the stent revascularisation on renal function and blood pressure control was promising.
Rastan
Aljoscha
A
Heart Centre Bad Krozingen, Bad Krozingen, Germany.
Krankenberg
Hans
H
Müller-Hülsbeck
Stefan
S
Sixt
Sebastian
S
Tübler
Thilo
T
Müller
Christian
C
Schwarzwälder
Uwe
U
Frank
Ulrich
U
Schwarz
Thomas
T
Leppaenen
Olli
O
Neumann
Franz-Josef
FJ
Zeller
Thomas
T
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006977:Hypertension, Renal / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D012079:Renal Circulation; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging / Q000209:etiology*; D015607:Stents; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex