title: Drug-eluting stents versus bare metal stents for the prevention of restenosis in patients with renovascular disease.
abstract: OBJECTIVE
  The aim of this study was to assess the impact of drug-eluting stents (DES) compared to bare metal stents (BMS) for the endovascular treatment of atherosclerotic renal artery stenosis (ARAS).
  
  
  RESULTS
  We retrospectively evaluated all of our endovascular BMS and DES implantations performed in de novo ARAS between 2000 and 2014 at our institution. The occurrence of in-stent restenosis (ISR) detected by ultrasound or angiography, kidney function, blood pressure (BP), and the number of antihypertensive drugs were analysed as endpoints. Overall, 338 renal arteries were treated in 298 patients. BMS were implanted in 163 (48%), and DES in 175 lesions (52%). Of the 175 lesions treated with DES, 55 (31%) were treated with a BMS-in-DES hybrid technique. For reasons of comparability, only lesions treated with balloon sizes of 4-6.5 mm were included in the final analysis. After 12 months, the rate of ISR >50% was 18.6% in the BMS group and 7.2% in the DES group (p=0.031). None of the BMS-in-DES-treated (hybrid) lesions developed ISR (hybrid technique vs. BMS only p=0.008, hybrid technique vs. DES only p=0.034). Systolic BP and number of antihypertensive drugs remained unchanged in the BMS group but declined in the DES group (p=0.02). Renal function significantly deteriorated in the BMS group (p=0.03) but did not change significantly in the DES group (p=0.188).
  
  
  CONCLUSIONS
  DES were superior to BMS in preventing ISR. Overall, the BMS-in-DES-technique (hybrid) achieved the lowest risk for ISR.
authors.affiliation: Medizinische Klinik und Poliklinik, Klinikum Rechts der Isar, Technische Universität München, Munich, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Bradaric
authors.forename: Kristin
authors.initials: K
authors.lastname: Eser
authors.forename: Stephanie
authors.initials: S
authors.lastname: Preuss
authors.forename: Michael
authors.initials: M
authors.lastname: Dommasch
authors.forename: Isabell
authors.initials: I
authors.lastname: Wustrow
authors.forename: Nicolas
authors.initials: N
authors.lastname: Langwieser
authors.forename: Bernhard
authors.initials: B
authors.lastname: Haller
authors.forename: Ilka
authors.initials: I
authors.lastname: Ott
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Fusaro
authors.forename: Uwe
authors.initials: U
authors.lastname: Heemann
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
authors.forename: Tareq
authors.initials: T
authors.lastname: Ibrahim
mesh_terms: D000368:Aged; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D054855:Drug-Eluting Stents; D005260:Female; D005858:Germany; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D011474:Prosthesis Design; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
chemical_list: D000959:Antihypertensive Agents; D008670:Metals