Selective stent placement versus balloon angioplasty for renovascular hypertension caused by Takayasu arteritis: Two-year results

Peng, Meng; Ji, Wei; Jiang, Xiongjing; Dong, Hua; Zou, Yubao; Song, Lingyun; Zhang, Huimin; Zhang, Weiguo; Yang, Yuejin; Gao, Runlin

doi:10.1016/j.ijcard.2015.12.006

Cited by 38 publications

(39 citation statements)

References 21 publications

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“…RAS was defined as a diameter reduction of ≥50%. Indications for endovascular therapy was defined as RAS ≥70% and Grade 3 hypertension without antihypertensive drugs, or systolic and diastolic pressures greater than 140 or 90 mmHg after treatment with triple antihypertensive drug therapy. The exclusion criteria for PTA with stent implantation were as follows: (a) intolerance to heparin or antiplatelet drugs, (b) renal artery dissection, (c) severe renal insufficiency (glomerular infiltration rate < 30 ml/min), (d) allergy to iodinated contrast agent, or (e) life expectancy <2 years.…”

Section: Methodsmentioning

confidence: 99%

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Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease

Yang

Dong

Jiang

et al. 2020

Cathet Cardio Intervent

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Objectives This study aimed to evaluate the safety and efficiency of percutaneous transluminal angioplasty (PTA) with selective stenting treating Chinese patients with renal artery stenosis (RAS) due to fibromuscular dysplasia (FMD). Background Endovascular data of patients with RAS caused by FMD are scarce in China. Methods Clinical data of 105 hypertensive patients with RAS caused by FMD underwent endovascular therapy at a single‐site between June 2001 and October 2018 were analyzed retrospectively. Baseline blood pressure, use of antihypertensive medications, renal function, and adverse events at a 1‐year follow‐up were evaluated. Results The patients were aged between 10 and 64 years (mean age 26.7 ± 8.2 years) and 52 (49.5%) were female. In total, 105 patients undergoing endovascular therapy involving 124 RASs. Thirty (24.2%), sixty‐four (51.6%), and thirty (24.2%) RASs were multifocal, unifocal, and tubular types, respectively. Ninety‐four (89.5%) and eleven (10.5%) patients underwent PTA alone and PTA plus stenting, respectively. The technical success rate for endovascular therapy was 95.2% (100/105) without severe complications. During 1‐year follow‐up (n = 100), the mean systolic and diastolic blood pressure decreased from 157.6 ± 17.5 and 102.3 ± 14.2 to 129.6 ± 12.3 and 81.3 ± 11.1 mmHg, respectively, and the number of antihypertensive medications reduced from 2.2 ± 1.2 to 0.8 ± 1.0 (all p < .001). The cure rate and improved rate of blood pressure was 49.0 and 40.0%, respectively. The serum creatinine levels remained stable. The primary and secondary restenosis rate was 13.4 and 5.8%, respectively. Conclusion Endovascular therapy for treating RAS caused by FMD was technically safe and effective for reducing blood pressure in Chinese patients.

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Section: Methodsmentioning

confidence: 99%

“…The procedural success of PTA was defined as residual stenosis of <50% in diameter. The procedural success of stent placement was defined as residual stenosis of <30% in diameter …”

Section: Methodsmentioning

confidence: 99%

Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease

Yang

Dong

Jiang

et al. 2020

Cathet Cardio Intervent

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“…Although cardiac catheterization was considered to be a treatment choice for vascular stenosis, we attempted the infusion of lipo-PGE1 owing to an increased risk of restenosis and vascular injury without complete abatement of inflammation [12]. …”

Section: Discussionmentioning

confidence: 99%

Continuous infusion of lipo-prostaglandin E1 for Takayasu’s arteritis with heart failure in an 11-month-old baby: a case report

et al. 2018

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BackgroundTakayasu’s arteritis is extremely rare in children aged below 6 years. At the onset of Takayasu’s arteritis in children, symptoms are varied but differ from those in adults. Corticosteroids are the mainstay of treatment for preventing irreversible vascular damage but there is no standard treatment for progressive vascular stenosis.Case presentationA Japanese 11-month-old baby boy presented with Takayasu’s arteritis and heart failure, possibly due to afterload mismatch caused by high blood pressure. Computed tomography was performed and revealed thoracic and abdominal aortic aneurysms. It also revealed severe celiac artery stenosis and bilateral renal artery stenosis. Prednisolone was initiated as first-line therapy. The fever resolved, and C-reactive protein levels returned to normal. Although his general condition improved, deterioration of vascular lesions was evident. Celiac artery occlusion, severe right renal artery stenosis, and new superior mesenteric artery stenosis were observed. We decided to use a continuous infusion of lipo-prostaglandin E1 for prevention of branch stenosis of his abdominal aorta. The progression of vascular stenosis was stopped and our patient’s cardiac function gradually improved.ConclusionsA differential diagnosis of heart failure with high blood pressure should be considered in babies. The progression of vascular stenosis may be suppressed by lipo-prostaglandin E1.

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“…In our patient, the Doppler signal did not change after antihypertensive therapy was prescribed. Percutaneous renal angioplasty is recommended as a safe and effective treatment in such cases without active arteritis, with a low complication rate and good prognosis …”

Section: Discussionmentioning

confidence: 99%

Type 3 takayasu arteritis diagnosed by parvus‐tardus renal Doppler signal modulation

Koç

2017

J of Clinical Ultrasound

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Takayasu's arteritis is known to cover the youngest age group in the etiology of secondary hypertension. The type 3 pattern is rare and involves the thoraco-abdominal aorta and its main abdominal branches. Here, we present the imaging results of a patient who had been followed up for systemic arterial hypertension and was diagnosed with Takayasu's arteritis type 3 by CT and MR angiography following bilateral detection of a parvus-tardus Doppler signal modulation in the renal arteries. We discuss the differential diagnoses that should be considered when observing a tardus-parvus Doppler signal. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:612-615, 2017.

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Selective stent placement versus balloon angioplasty for renovascular hypertension caused by Takayasu arteritis: Two-year results

Cited by 38 publications

References 21 publications

Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease

Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease

Continuous infusion of lipo-prostaglandin E1 for Takayasu’s arteritis with heart failure in an 11-month-old baby: a case report

Type 3 takayasu arteritis diagnosed by parvus‐tardus renal Doppler signal modulation

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