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Titolo:
TREATMENT OF OSTIAL RENAL-ARTERY STENOSES WITH VASCULAR ENDOPROSTHESES AFTER UNSUCCESSFUL BALLOON ANGIOPLASTY
Autore:
BLUM U; KRUMME B; FLUGEL P; GABELMANN A; LEHNERT T; BUITRAGOTELLEZ C; SCHOLLMEYER P; LANGER M;
Indirizzi:
UNIV HOSP FREIBURG,DEPT DIAGNOST RADIOL,HUGSTETTER STR 55 D-79106 FREIBURG GERMANY UNIV HOSP FREIBURG,DEPT INTERNAL MED 4 NEPHROL D-79106 FREIBURG GERMANY
Titolo Testata:
The New England journal of medicine
fascicolo: 7, volume: 336, anno: 1997,
pagine: 459 - 465
SICI:
0028-4793(1997)336:7<459:TOORSW>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANS-LUMINAL ANGIOPLASTY; RENOVASCULAR HYPERTENSION; STENT PLACEMENT; WALLSTENT ENDOPROSTHESIS; ISCHEMIC NEPHROPATHY; NATURAL-HISTORY; FOLLOW-UP; DISEASE; INSUFFICIENCY; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
U. Blum et al., "TREATMENT OF OSTIAL RENAL-ARTERY STENOSES WITH VASCULAR ENDOPROSTHESES AFTER UNSUCCESSFUL BALLOON ANGIOPLASTY", The New England journal of medicine, 336(7), 1997, pp. 459-465

Abstract

Background Percutaneous transluminal renal angioplasty is a safe and effective treatment for nonostial stenoses of the renal arteries, but it has proved to be disappointing for ostial stenoses. Therefore, we prospectively studied the use of intravascular stents for the treatmentof critical ostial stenoses after unsuccessful balloon angioplasty. Methods Stainless-steel endoprostheses were placed across 74 renal-artery stenoses located within 5 mm of the aortic lumen in 68 patients with hypertension. Twenty patients had mild or severe renal dysfunction. The indications for stent placement were elastic recoil (63 arteries) or dissection (1 artery) of the vessel after angioplasty, or restenosis after initially successful balloon angioplasty (10 arteries). Patients were followed for a mean of 27 months with measurements of blood pressure and serum creatinine, duplex sonography, and intraarterial angiography. Results Initial technical success was achieved in all patients. Minor complications (local hematomas) occurred in only three patients; there were no major complications. Eighty-four percent of the patients were free of primary occlusion 60 months after the procedure. Restenosis of more than 50 percent of the vessel diameter occurred in 8 of 74 arteries (11 percent). Reintervention resulted in a secondary patency rate of 92 percent. Long-term normalization of blood pressure wasachieved in 11 patients (16 percent). Serum creatinine levels did notchange significantly after successful stent implantation in patients with previously impaired renal function. Conclusions Accurate placement of renal-artery stents is technically feasible without major complications. The favorable early and long-term results suggest that primarystent placement is Bn effective treatment for renal-artery stenosis involving the ostium. (C)1997, Massachusetts Medical Society.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 19/09/20 alle ore 12:30:36