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Titolo:
Endovascular revascularization of renal artery stenosis: Technical and clinical results
Autore:
Bush, RL; Najibi, S; MacDonald, J; Lin, PH; Chaikof, EL; Martin, LG; Lumsden, AB;
Indirizzi:
Emory Univ Hosp, Div Vasc Surg, Atlanta, GA 30322 USA Emory Univ Hosp Atlanta GA USA 30322 Div Vasc Surg, Atlanta, GA 30322 USA Emory Univ, Sch Med, Div Gen Vasc Surg, Joseph B Whitehead Dept Surg, Atlanta, GA 30322 USA Emory Univ Atlanta GA USA 30322 hitehead Dept Surg, Atlanta, GA 30322 USA Emory Univ, Sch Med, Dept Intervent Radiol, Atlanta, GA 30322 USA Emory Univ Atlanta GA USA 30322 t Intervent Radiol, Atlanta, GA 30322 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 5, volume: 33, anno: 2001,
pagine: 1041 - 1049
SICI:
0741-5214(200105)33:5<1041:ERORAS>2.0.ZU;2-3
Fonte:
ISI
Lingua:
ENG
Soggetto:
STENT PLACEMENT; RENOVASCULAR HYPERTENSION; BALLOON ANGIOPLASTY; FOLLOW-UP; WALLSTENT ENDOPROSTHESIS; DUPLEX ULTRASONOGRAPHY; PALMAZ STENT; RECONSTRUCTION; MANAGEMENT; IMMEDIATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Lumsden, AB Emory Univ Hosp, Div Vasc Surg, 1364 Clifton Rd,Room H124A, Atlanta, GA 30322 USA Emory Univ Hosp 1364 Clifton Rd,Room H124A Atlanta GA USA 30322
Citazione:
R.L. Bush et al., "Endovascular revascularization of renal artery stenosis: Technical and clinical results", J VASC SURG, 33(5), 2001, pp. 1041-1049

Abstract

Purpose: The natural history of renal artery stenosis is progression with subsequent deterioration of kidney function and development of renovascularhypertension. Percutaneous transluminal renal angioplasty is effective in the treatment of nonostial lesions but less effective for ostial stenoses. because of the poor technical success experienced with percutaneous transluminal renal angioplasty, stenting of ostial stenoses is becoming the standard of endovascular care. In this retrospective study we analyzed the technical and clinical outcomes after renal artery stenting in 73 consecutive patients. Patients and Methods: From July 1992 to January 1999, 88 Palmaz stents were deployed in 85 renal artery stenoses in 73 patients, with a mean age of 67.9 +/- 9.4 years. Twelve patients (16%) underwent bilateral stent placement. Atheromatous lesions were the most prevalent (99%: 82% ostial, 16% nonostial). Most stents were implanted for suboptimal balloon dilation (52%) or dissection (24%). Mean percent stenosis was 86% +/- 12%. Renal insufficiency (creatinine level greater than or equal to 1.5 mg/dL) was present in 50 (68%) patients, and uncontrolled hypertension (systolic greater than or equal to 160 mm Hg or diastolic greater than or equal to 90 mm Hg with more than two medications) was present in 57 (78%). Results: Primary technical success was achieved in 89%. At the initial procedure, three additional stents were placed for residual stenoses, and urokinase was used to treat one intraprocedural stent thrombosis, resulting in an assisted primary technical success rate of 94%. Major complications occurred in 9.1% of stents placed: access artery thrombosis (n = 4), renal artery extravasation (n = 1), renal artery thrombosis (n = 1), and hematoma requiring operation (n = 2). Long-term clinical data were available on 69 (95%) patients at 20 +/- 17 months. Overall, a significant decrease in systolicand diastolic pressures (P < .001) and reduction of medication (P < .01) were noted without a change in renal function (P = NS), Angiography was performed on 22 patients at 11.3 +/- 10.3 months for persistent or worsening renal function or hypertension or for other reasons; 10 patients had significant restenoses in 14 renal arteries. Conclusion: Our retrospective analysis demonstrates that endovascular stenting of renal artery stenosis in patients with poorly controlled hypertension or deteriorating renal function is a safe and effective alternative treatment to surgical management.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 20/09/20 alle ore 09:52:49