title: Long term results of endovascular treatment in renal arterial stenosis from Takayasu arteritis: angioplasty versus stent placement.
abstract: OBJECTIVE
  To retrospectively evaluate and compare the long term patency and antihypertensive effect of angioplasty and stent insertion in renal artery stenosis caused by Takayasu arteritis, with CT angiography and clinical follow-up.
  
  
  METHODS
  We retrospectively analyzed and compared effects on hypertension and patency of renal artery in 16 patients (age ranging from 16 to 58 years, mean: 32.1 years) with renovascular hypertension caused by Takayasu arteritis who underwent endovascular treatment including angioplasty (n=13) and stent placement (n=9) for 22 stenotic renal arteries.
  
  
  RESULTS
  Technical success was 95% (21/22) without major complications. In the last follow-up CT angiogram (mean 85 ± 41 months), restenosis was 8% (1/12) in angioplasty and 66% (6/9) in stent. Patency rates of angioplasty were 100%, 91.7%, 91.7% and primary unassisted and primary assisted patency rates of stent placement were 55.6%, 33.3%, 33.3% and 88.9%, 66.7%, 55.6% at 1-, 3- and 5-years, respectively. In clinical follow-up (mean 120 ± 37.8 months, range 48-183 months), beneficial effects on hypertension were obtained in 87% of patients (13/15) and there was no significant difference between the patients who were treated by only angioplasty and the patients who received stent placement in at least one renal artery, regardless of whether or not angioplasty had been performed in the other renal artery.
  
  
  CONCLUSIONS
  Compared with stent placement, angioplasty demonstrated better long term patency and similar clinical benefit on renovascular hypertension in renal artery stenosis of Takayasu arteritis. We suggest that stent placement should be reserved for obvious angioplasty failure.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710 Seoul, Republic of Korea. Electronic address: hongsukpark@gmail.com.
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.forename: Duk-Kyung
authors.initials: DK
authors.lastname: Kim
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Choo
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Dongho
authors.initials: D
authors.lastname: Hyun
authors.forename: In Wook
authors.initials: IW
authors.lastname: Choo
mesh_terms: D000293:Adolescent; D000328:Adult; D000792:Angiography / Q000379:methods; D017130:Angioplasty; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents; D013625:Takayasu Arteritis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Angioplasty; Hypertension; Renal; Stents; Takayasu arteritis; Vasculitis