Long-Term Outcomes and Causes of Death in Patients With Renovascular Disease Undergoing Renal Artery Stenting

Abstract

Renovascular disease (RVD) can lead to hypertension and chronic kidney disease (CKD). Patients with advanced peripheral arterial disease (PAD) have a 5-year mortality of ~30%. Rate and causes of death in patients with significant RVD, who share similar risk factors with PAD patients, are not well defined. We assessed consecutive RVD patients who underwent renal artery stenting at our institution over 6 years. Specific causes of death were ascertained and the probability of survival was estimated. Cox models were fit to identify predictors of outcomes. We identified 281 RVD patients who underwent renal stenting. Follow-up was available for all patients (median 5.1 years). All-cause mortality was 24.2% at 5 years and 33.7% at 7 years (compounded annualized death rate: 5.5%). Of the 68 deaths, 36 (52.9%) were cardiovascular (13.2% acute myocardial infarction, 13.2% stroke, 11.8% sudden death and 10.3% congestive heart failure); 32 (47.1%) deaths had non-cardiovascular causes. In RVD patients undergoing stenting, cardiovascular events are the most common causes of death. Compared with patients with advanced PAD, RVD may have a lower 5-year mortality.

Long-term outcome of stenting for atherosclerotic renal artery stenosis and the effect of angiographic restenosis

“…However, the long follow-up of more than ten years (median = 11 years 7 months) distinguishes our study from other, similar reports (2,9,10). Only one previous study had almost as long a follow-up, approaching ten years after PTRA (24).…”

“…Restenosis typically occurs during the first postoperative year, but it is unclear if its appearance affects the long-term prognosis. In fact, there is little information in the literature on long-term outcome after PTRA beyond the first few years (2,9,10).…”

Development and characterization of an ex vivo arterial long-term proliferation model for restenosis research

“…In a next step we investigated the effect of BMS and several DES on the reseeded vessels over a time period of 12 weeks. After stent implantation in our model, the expected significant differences in cellular proliferation rates between DES and BMS could be observed (Wallace et al, 2012;Fusaro et al, 2013). Within the DES group, no significant difference in the proliferation area was found, however there is a trend separating "limus" eluting stents (Xience: everolimus, Resolute Integrity: zotarolimus) and paclitaxel eluting stents (PES).…”