<b>Effect of Renal Artery Stenting on Renal Function in Patients With Ischemic Nephropathy</b>

Abstract

SUMMARYThe aim of this study was to evaluate the effects of stenting on blood pressure and renal functions in azotemic patients with proximal/ostial atherosclerotic renal artery stenosis.Thirteen azotemic patients (5 females, 8 males, average age, 62.7 ± 8.3 years) who had renal artery stenosis were included in the study. Their blood pressure, estimated glomerular filtration rate (EGFR), and creatinine levels were measured at baseline and during follow-up.Stents were implanted successfully in all of the cases. The average stent diameter and stent length were 7.2 ± 0.5 mm and 17.2 ± 3.4 mm, respectively. Antihypertensive drug was abandoned in 1 (7.6%) patient, reduced in 10 patients (76.9%), and not changed in 2 (15.3%) patients. Significant improvement was observed in the mean serum creatinine level at the 12 th month when compared with baseline (2.56 ± 0.88; 1.83 ± 0.62, P < 0.001). EGFR was 18.38 ± 4.64 before the procedure and 22.67 ± 3.81 during follow-up (P < 0.0001). According to the EGFR criteria, renal function was determined to be worse in 1 (7.6%) patient, stabilized in 2 (15.3%), and improved in 10 (76.9%) patients. One patient died during the follow-up period. Angiographic restenosis was observed in 2 (15.3%) patients. Follow-up major events were observed in 3 (23%) patients.Stenting azotemic patients with renal artery stenosis is a reliable and effective procedure for achieving an improvement in renal function. (Jpn Heart J 2004; 45: 637-645)

Transradial Renal Artery Angioplasty and Stenting in a Patient With Leriche Syndrome

“…[1][2][3] Because of its low morbidity and mortality, it usually results in better control of hypertension and leads to improvement or preservation of renal functions. Moreover, from recent reports, it has been clarified that primary renal stent placement is superior to renal balloon angioplasty alone in view of the angiographic results, the functional results, and vessel patency, particularly in ostial lesions characterized by a high restenosis rate.…”

“…The serum level of plasma renin activity was 2.70 ng/mL/ hour (normal range, 0.20-2.70). An ECG taken 18 years prior to admission was normal, whereas that taken on admission showed negative T waves in leads I, a VL, and V [1][2][3][4][5][6] . Two-dimensional transthoracic echocardiography revealed that the apical wall of the left ventricle was thin and dyskinetic, suggesting an apical old myocardial infarction.…”

“…[1][2][3] The most frequent access site for endovascular treatment of RAS is the common femoral artery. However, in the case of RAS accompanied by an acute aorto-renal angle or severe peripheral arterial obstructions, a brachial or axillary approach has been traditionally used.…”

Effect of baseline glomerular filtration rate on renal function following stenting for atherosclerotic renal artery stenosis

“…Percutaneous transluminal renal angioplasty and stenting (PTRAS) is intended to replace open surgical revascularization operations as the treatment of choice for atherosclerotic renovascular disease (RVD) [13][14][15]. PTRAS is not only a less invasive procedure but is also associated with fewer complications and lower procedure-related mortality rates [16,17].…”

Management of atherosclerotic renovascular disease: the effect of renal artery stenting on renal function and blood pressure

“…During the last few years, percutaneous transluminal renal angioplasty (PTRA) with concomitant use of renal stenting (PTRAS) attempts to replace open surgical revascularization operations as the treatment of choice for atherosclerotic renovascular disease [11][12][13]. PTRAS is not only a less invasive procedure, but it is also associated with minimal complication and procedure-related mortality rates [14,15].…”