Low-profile Stent System for Treatment of Atherosclerotic Renal Artery Stenosis: The GREAT Trial

Embolic Protection and Platelet Inhibition During Renal Artery Stenting

“…[21][22][23] The use of stents, albeit somewhat controversial, is often advocated to improve blood pressure, to manage nephropathy, or to control heart failure symptoms. 24 In this setting, considerable interest exists in identifying strategies that improve renal outcomes.…”

Percutaneous revascularization of persistent renal artery in-stent restenosis

“…28 The GREAT trial prospectively compared DES (low-profile Palmaz-Genesis peripheral stent) to bare metal stents (BMS) in the renal artery in a non-randomized prospective study. 29 This trial, however, failed to show an advantage for DES over BMS at 6 months of angiographic follow-up. Case reports have noted the potential use of atheroablative techniques in cases of recurrent RAS.…”

“…[28][29][30][31][32][33][34][35][36][37][38] To our knowledge, a trial published by Gaxotte et al contains the only reported use of Jostents for ISR in a very small number of renal arteries and also iliac arteries. The JOSTENT stent-graft contains a layer of PTFE sandwiched between two stainless steel stents.…”

Atherosclerotic Peripheral Vascular Disease Symposium II

“…The efficacy of a sirolimus drug-eluting stent in the renal circulation has been studied in a small feasibility trial, the GREAT trial (Palmaz Genesis Peripheral Stainless Steel Balloon Expandable Stent in Renal Artery Treatment), in which 6-month follow-up data demonstrated a decrease in renal ISR from 14% in the bare-stent group to 6.7% in the drug-eluting stent cohort on the basis of follow-up angiography. 44 Use of cutting balloons, lasers, and atherectomy devices for renal ISR has been reported, but no significant cases series or trials of these devices in the renovascular system are available. 45 In addition, there are no data on the use of statins, antiplatelet agents, drug-coated balloons, or oral antiproliferative agents and their effects on reducing renal ISR, although there are some encouraging preliminary data in the coronary literature.…”