title: Selective stent placement versus balloon angioplasty for renovascular hypertension caused by Takayasu arteritis: Two-year results.
abstract: OBJECTIVE
  We aimed to investigate the long-term clinical outcomes of selective stenting versus percutaneous balloon angioplasty (PTA) in hypertensive patients with renal artery stenosis caused by Takayasu arteritis (RASTA).
  
  
  METHODS
  We retrospectively analyzed the data of consecutive 152 RASTA patients from Fuwai Hospital between 2005 and 2012. All target lesions of renal arteries were firstly treated by plain PTA. After angioplasty, if flow-limited dissection and/or residual stenosis >50% of diameter on angiogram existed, a selective stenting was then followed to further morphological improvement.
  
  
  RESULTS
  The baseline characteristics between PTA (n=93) and stenting groups (n=59) were indistinguishable. At two-year follow-up, the rates of normalized, improved, and unaltered hypertension were 27.4%, 63.4% and 12.3% in PTA group (n=93) versus 22.4%, 62.1% and 15.5% respectively in stenting group (p=0.79). Primary patency rate was 90.1% in renal arteries (125 lesions) treated with PTA versus 75.6% in renal arteries (64 lesions) treated with stent placement (p=0.008). Female, active stage of the disease requiring glucocorticoid and/or immunosuppressant agents, residual stenosis rate and stenting were significantly associated with the restenosis. In patients with restenosis, renal artery occlusion occurred more in stenting group (8/15), compared with that in PTA group (1/12) (p=0.019). The stenting group underwent more reintervention procedures than PTA group (13/63 versus 8/125, p=0.003).
  
  
  CONCLUSIONS
  If PTA alone failed in treating RASTA, selective stenting resulted in similarly effective blood pressure reduction. Stenting also resulted in lower 2-year primary patency rate, higher occlusion rate and higher reintervention rate than those who did not need stenting.
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Peng
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ji
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China. Electronic address: jiangxiongjing@163.com.
authors.forename: Xiongjing
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Dong
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Yubao
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Huimin
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Cardiovascular and Neurologic Institute, Irving, TX 75039, USA.
authors.forename: Weiguo
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
mesh_terms: D000328:Adult; D000800:Angioplasty, Balloon / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D013625:Takayasu Arteritis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Angioplasty; Clinical outcome; Hypertension; Renal artery stenosis; Stent placement; Takayasu arteritis