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Stenting in Renal Artery StenosisBackground Renal artery stenosis RAS is a major cause of renovascular hypertension and reduced renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS.Method From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis 11 male, 6 female . The mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu s disease in 2, and autoimmune disease Bechet's in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination.Result The degree of renal artery stenosis was 83% 70 95% . The lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-II stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There was no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases.Conclusion Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.KEY WORDS Renal artery stenosis·Renal stent. 서 론

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Percutaneous transluminal angioplasty PTA was first described by Dotter and Jukins in 1964 and subsequently modified by Gruentzig and Hoff in 1974. PTA has proved a safe and effective treatment for focal atherosclerotic disease of the aorta and its major extremity branches. The complications of PTA of the peripheral vessels are less frequent and less severe than those associated with the comparable surgical procedure. Intestinal angina is a clinical syndrome compromising postprandial abdominal pain, nausea, vomiting, diarrhea, weight loss, and eventually fear of eating. The syndrome is thought to be due to visceral ischemia, with stenosis or occlusion of two of the three visceral arteries being necessary for the syndrome to occur. Although the first report of mesenteric PTA appeared in 1980, the series of PTA with stenting of the visceral arteries reported in the literature have been small or included limited follow-up. We report a case of a intestinal angina due to superior mesenteric arterial stenosis. A 69-year-old male complained of severe postprandial pain, chronic diarrhea for 1 year. PTA with stening in superior mesenteric artery result in recannulation of obstructed artery and relief of symptom.KEY WORDS PTA with stenting·Superior mesenteric artery stenosis·Intestinal angina. 서 론

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