Should percutaneous transluminal renal artery angioplasty be applied to ostial renal artery atherosclerosis?

Abstract

Modest success at low risk can be expected from PTRA in a group of patients with severe atherosclerosis. No significant difference in results between ostial and nonostial lesions was noted.

Treatment of Ostial Renal-Artery Stenoses with Vascular Endoprostheses after Unsuccessful Balloon Angioplasty

“…[7][8][9][10][11] In pa-R tients with obstruction of inflow to the renal artery due to an aortic plaque, however, the results of balloon angioplasty have been disappointing. The initial success rates range from 24 to 35 percent, [10][11][12][13] and the rates of recurrence of the lesions from 15 to 42 percent. [14][15][16] Therefore, this type of renovascular disease is commonly treated by primary surgical intervention.…”

Behandlung von ostiumnahen Nierenarterienstenosen mit einem neuen, fest vormontierten, ballonexpandierbaren Stent

“…Im Gegensatz zu den guten Ergebnissen einer PTRA bei Patienten mit fibromuskulärer Dysplasie [4] oder einer postostialen atherosklerotischen Stenose [5] sind die Erfolge einer PTRA zur Behandlung der häufigsten Form der NAST, der ostialen atherosklerotischen Stenose, wegen der primären Erfolgsrate von 10 ± 40 % [5 ± 8] nicht zufriedenstellend. Nach Dilatation kommt es in 15 ± 82 % der Läsionen wieder zu Stenosen [7,9,10]. Diese schlechten Ergebnisse werden durch das elastische Recoil von aortalen Plaques erklärt, welche in das Ostium der Nierenarterienabgänge hineinragen [11] Literatur…”

Metal Stents for the Management of Atherosclerotic Renovascular Disease

“…Approximately two thirds of the cases are of an atherosclerotic nature. [1][2][3][4][5][6][7][8] Atherosclerotic stenosis located in the truncus of the renal artery can be treated by standard percutaneous transluminal angioplasty (PTA) in most patients. Ostial stenosis is less easy to treat, and the rates of acute failure and late restenosis range from 9% to 76% and 25% to 45%, respectively.…”

“…Ostial stenosis is less easy to treat, and the rates of acute failure and late restenosis range from 9% to 76% and 25% to 45%, respectively. [1][2][3][4][5][6][7][8] Vascular endoluminal stents were first introduced for coronary and peripheral circulation. They are now an alternative, clinically valuable modality that can relieve renal artery obstruction and restore renal blood flow.…”

“…They provide mechanical scaffolding, prevent elastic recoil, and repair arterial dissection while maintaining vessel patency. [1][2][3][4][5][6][7][8][9][10][11][12] We report on our experience with the use of metal stents for the treatment of ostial atherosclerotic renovascular disease.…”