Sustained beneficial effects on blood pressure during long time retrospective follow-up after endovascular treatment of renal artery occlusion

Abstract

We retrospectively evaluated short-and long-term effects of percutaneous transluminal renal angioplasty (PTRA) with or without stent placement of renal artery occlusion (RAO) upon blood pressure (BP), serum (s)-creatinine, and the need for antihypertensive treatment in 34 RAO patients who underwent PTRA during 1996-2002. In 24/34 (71%) treatment was considered technically successful, 22/24 (92%) were treated with PTRA þ stent, two with only PTRA. Patients were followed for mean 2.6 (range 0-8) years, during which 14/34 (41%) patients died. In all 34 patients, systolic and diastolic BP (SBP and DBP) before treatment were 184730/95715 mmHg and had decreased at discharge (to 157721/80710 mmHg; Po0.001 for both SBP and DBP), and remained lower after 1 year (154720/ 8377 mmHg;Po0.001 for SBP and Po0.01 for DBP), and at last follow-up (148720/80712 mmHg; Po0.001 for both SBP and DBP). No changes occurred in s-creatinine or the number of antihypertensive drugs. Similar results were seen in the subgroup of 24/34 (71%) patients in whom treatment was technically successful. Among the 24 patients undergoing technically successful PTRA, absence of nephrosclerosis (P ¼ 0.035) and a shorter duration of hypertension (P ¼ 0.020) predicted favourable clinical outcome. No adverse effects upon s-creatinine or the need for antihypertensive medication were seen in patients in whom treatment was considered a technical failure. Seven of these patients were treated with PTRA of another renal artery than the occluded, or with embolisation. In conclusion, RAO can be treated with endovascular techniques. Technically successful results with decreasing blood pressure levels were obtained in 71% of patients.

Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis

“…s-creatinine stabilised or improved in all of these, and also declined significantly in the whole cohort. This is in contrast to our findings in patients with atherosclerotic renal artery stenosis 21 and occlusion, 22 in which s-creatinine levels were unchanged during followup.…”