Surgery after failed percutaneous renal artery angioplasty

Abstract

Operative repair after F-PTRA was altered in 59% of the patients with atherosclerosis and in 68% of patients with FMD. Blood pressure benefit for patients with FMD was unchanged after F-PTRA. However, the blood pressure benefit was significantly decreased among patients with atherosclerosis. Decreased EGFR after F-PTRA was recovered with operative renal artery repair. However, postoperative EGFR as compared with EGFR prior to PTRA was unchanged. Blood pressure and renal function response after F-PTRA for atherosclerotic renovascular disease warrants further study.

Renal artery revascularization after unsuccessful percutaneous therapy: a single centre experience

“…Renal function in atherosclerotic RAS pretreated by PTRA did not improve as well as in non-atherosclerotic patients [13,14]. This is in agreement with our own findings: in atherosclerotic RAS we found a stabilization of eGFR, whereas in patients with FMD, there was no deterioration of the average normal eGFR.…”

“…In atherosclerotic RAS, Wong et al showed cure of hypertension in 7%, improvement in 50% and unchanged hypertension in 43% of all patients (n=28) [14]. Lacombe and Ricco report similar results with improvement in 53% and unchanged hypertension in 43% (n=17) [13].…”

“…Wong et al encountered problems during surgical revascularization after unsuccessful angioplasty in 50% of patients presenting with atherosclerosis and 65% of patients with arterial fibrodysplasia [14]. Conversely, McCann et al, Martinez et al and Desay et al noted no difference in surgical feasibility after failed or complicated PTRA [15][16][17].…”

Successful management of a resistant renal artery stenosis in a child using a 4 mm cutting balloon catheter

“…The technical results of PTRA in adults range from 47% to 90% [1,8,10,24,25]. Ostial arteriosclerotic stenosis show disappointing success rates from 24% to 35%.…”

“…The inability to cross the lesion with a guidewire/balloon may be one reason for the primary failure rate [2,11,24,31]. Lesions resistant to dilatation with balloon inflation to 6 atm pressure can be treated using high-pressure balloons [6,14].…”