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Vol 7, No 4 (2005)
Published online: 2006-02-06
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The results of percutaneous angioplasty and stent implantation for critical ostial renal artery stenosis

Wacław Kuczmik, Damian Ziaja, Tomasz Orawczyk, Tomasz Ludyga, Teresa Kowalewska-Twardela, Jakub Gęborski, Krzysztof Ziaja
DOI: 10.5603/chp.28916
·
Chirurgia Polska 2005;7(4):217-223.

open access

Vol 7, No 4 (2005)
Published online: 2006-02-06

Abstract

Background: Atherosclerosis and fibromuscular dysplasia are significant causes of renal artery stenosis, which frequently leads to arterial hypertension and renal failure. Treatment may consist of surgical revascularization or percutaneous angioplasty with stent implantation. This study was designed to evaluate the response to endovascular treatment for critical stenosis of the renal arteries in patients with severe arterial hypertension and renal failure.
Material and method: From the year 2000 through 2003 percutaneous angioplasty with stenting of renal artery stenosis was performed in 25 patients. The study group comprised 8 male and 17 female patients, aged 43 to 79 years (mean age: 59.6 years). Arterial hypertension was the indication for surgery in twentyfour patients, 5 of whom also suffered from chronic renal failure. One patient was selected due to acute renal failure. Patient selection was based on the presence of critical ostial stenosis (> 70%) of the renal artery. Seven patients (28%) presented with bilateral stenosis; two others had occlusion of the contralateral renal artery with renal cirrhosis.
Results: Technically, stent implantation was 100% success. A perioperative creatnine increase (> 1.5 mg%) was observed in 11 patients (44%). Two patients required kidney dialysis; one of whom developed multiorgan failure, and subsequently myocardial infarction, which was the immediate cause of death. Following the procedure, a decline in blood pressure or a decrease in the number and dose of antihypertensive drugs was observed in 19 subjects (76%); however, the effect proved shortlasting in most of them. Significant restenosis (> 50%) was found in 2 patients (8%). Two others (8%) developed perioperative haematomas at the arterial puncture site.
Conclusions: Percutaneous angioplasty, in patients with critical ostial stenosis of the renal arteries and resultant hypertension, is a safe method of treatment and yields a decline in blood pressure or a decrease in the number and dose of antihypertensive drugs in most patients.

Abstract

Background: Atherosclerosis and fibromuscular dysplasia are significant causes of renal artery stenosis, which frequently leads to arterial hypertension and renal failure. Treatment may consist of surgical revascularization or percutaneous angioplasty with stent implantation. This study was designed to evaluate the response to endovascular treatment for critical stenosis of the renal arteries in patients with severe arterial hypertension and renal failure.
Material and method: From the year 2000 through 2003 percutaneous angioplasty with stenting of renal artery stenosis was performed in 25 patients. The study group comprised 8 male and 17 female patients, aged 43 to 79 years (mean age: 59.6 years). Arterial hypertension was the indication for surgery in twentyfour patients, 5 of whom also suffered from chronic renal failure. One patient was selected due to acute renal failure. Patient selection was based on the presence of critical ostial stenosis (> 70%) of the renal artery. Seven patients (28%) presented with bilateral stenosis; two others had occlusion of the contralateral renal artery with renal cirrhosis.
Results: Technically, stent implantation was 100% success. A perioperative creatnine increase (> 1.5 mg%) was observed in 11 patients (44%). Two patients required kidney dialysis; one of whom developed multiorgan failure, and subsequently myocardial infarction, which was the immediate cause of death. Following the procedure, a decline in blood pressure or a decrease in the number and dose of antihypertensive drugs was observed in 19 subjects (76%); however, the effect proved shortlasting in most of them. Significant restenosis (> 50%) was found in 2 patients (8%). Two others (8%) developed perioperative haematomas at the arterial puncture site.
Conclusions: Percutaneous angioplasty, in patients with critical ostial stenosis of the renal arteries and resultant hypertension, is a safe method of treatment and yields a decline in blood pressure or a decrease in the number and dose of antihypertensive drugs in most patients.
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Keywords

renal artery stenosis; angioplasty; stents; arterial hypertension; renal failure

About this article
Title

The results of percutaneous angioplasty and stent implantation for critical ostial renal artery stenosis

Journal

Chirurgia Polska (Polish Surgery)

Issue

Vol 7, No 4 (2005)

Pages

217-223

Published online

2006-02-06

Page views

485

Article views/downloads

1347

DOI

10.5603/chp.28916

Bibliographic record

Chirurgia Polska 2005;7(4):217-223.

Keywords

renal artery stenosis
angioplasty
stents
arterial hypertension
renal failure

Authors

Wacław Kuczmik
Damian Ziaja
Tomasz Orawczyk
Tomasz Ludyga
Teresa Kowalewska-Twardela
Jakub Gęborski
Krzysztof Ziaja

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