Treating Renal Artery Stenosis

Schillinger, Martin; Minar, Erich; Ahmadi, Ramazanali

doi:10.1007/s00059-004-2533-0

Cited by 6 publications

(1 citation statement)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…RAS can be detected by arteriography and by other noninvasive imaging methods, such as magnetic resonance angiography (MRA), computed tomography angiography (CTA), and duplex ultrasound 4. The detection of stenosis alone does not guarantee the presence of RVH and may not be sufficient for defining a particular prognosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

Chaves

Buchpiguel

Praxedes

et al. 2010

Clinics

View full text Add to dashboard Cite

INTRODUCTION:Renal artery stenosis can lead to renovascular hypertension; however, the detection of stenosis alone does not guarantee the presence of renovascular hypertension. Renovascular hypertension depends on activation of the renin-angiotensin system, which can be detected by functional tests such as captopril renal scintigraphy. A method that allows direct measurement of the baseline and post-captopril glomerular filtration rate using chromium-51 labeled ethylenediamine tetraacetic acid (51Cr-EDTA) could add valuable information to the investigation of hypertensive patients with renal artery stenosis. The purposes of this study were to create a protocol to measure the baseline and post-captopril glomerular filtration rate using 51Cr-EDTA, and to verify whether changes in the glomerular filtration rate permit differentiation between hypertensive patients with and without renal artery stenosis.METHODS:This prospective study included 41 consecutive patients with poorly controlled severe hypertension. All patients had undergone a radiological investigation of renal artery stenosis within the month prior to their inclusion. The patients were divided into two groups: patients with (n=21) and without renal artery stenosis, (n=20). In vitro glomerular filtration rate analysis (51Cr-EDTA) and 99mTc-DMSA scintigraphy were performed before and after captopril administration in all patients.RESULTS:The mean baseline glomerular filtration rate was 48.6±21.8 ml/kg/1.73 m2 in the group wuth renal artery stenosis, which was significantly lower than the GFR of 65.1±28.7 ml/kg/1.73m2 in the group without renal artery stenosis (p=0.04). Captopril induced a significant reduction of the glomerular filtration rate in the group with renal artery stenosis (to 32.6±14.8 ml/ kg/1.73m2, p=0.001) and an insignificant change in the group without RAS (to 62.2±23.6 ml/kg/1.73m2, p=0.68). Scintigraphy with technetium-99m dimercapto-succinic acid (DMSA) did not show significant differences in differential renal function from baseline to post-captopril images in either group.CONCLUSIONS:Captopril induced a decrease in the GFR that could be quantitatively measured with 51Cr-EDTA. The reduction is more pronounced in hypertensive patients with RAS.

show abstract

Section: Introductionmentioning

confidence: 99%

Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

Chaves

Buchpiguel

Praxedes

et al. 2010

Clinics

View full text Add to dashboard Cite

show abstract

Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

Vignali

Bargellini

Lazzereschi

et al. 2005

Cardiovasc Intervent Radiol

View full text Add to dashboard Cite

show abstract

Drug-eluting stents in renal artery stenosis

Zähringer

Pattynama

Talen³

et al. 2007

Eur Radiol

View full text Add to dashboard Cite

Because of higher acute and long-term success rates compared with balloon angioplasty alone, percutaneous stent implantation has become an accepted therapy for the treatment of atherosclerotic renal artery stenosis. Restenosis rates after successful renal stent placement vary from 6 up to 40%, depending on the definition of restenosis, the diameter of the treated vessel segment and comorbidities. The safety and efficacy of drug-eluting stents for the treatment of renal-artery stenosis is poorly defined. The recently published GREAT study is the only prospective study, comparing bare-metal and sirolimus-coated low profile stent systems in renal artery stenosis, showing a relative risk reduction of angiographic binary in-stent restenosis by 50%. This is an opinion paper on indications, current treatment options and restenosis rates following renal artery stenting and the potential use of drug-eluting stents for this indication.

show abstract

Treating Renal Artery Stenosis

Cited by 6 publications

References 37 publications

Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

Glomerular Filtration Rate Measured by 51Cr-EDTA Clearance: Evaluation of Captopril-Induced Changes in Hypertensive Patients with and without Renal Artery Stenosis

Predictive Factors of In-Stent Restenosis in Renal Artery Stenting: A Retrospective Analysis

Drug-eluting stents in renal artery stenosis

Contact Info

Product

Resources

About