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Protected renal stenting with the PercuSurge GuardWire device: a pilot study.

M Henry¹, C Klonaris, I Henry

¹m.henryilrmdt@wanadoo.fr

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists

|August 9, 2001

Summary

Renal artery angioplasty with distal protection is feasible and safe, reducing atheroembolism risk. This technique shows promise for improving blood pressure and renal function in patients with renal artery stenosis.

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Area of Science:

Interventional Cardiology
Vascular Surgery
Nephrology

Background:

Atherosclerotic renal artery stenosis is a significant cause of secondary hypertension and renal insufficiency.
Intraprocedural atheroembolism is a known complication of renal artery interventions.
Distal protection devices aim to mitigate embolic events during endovascular procedures.

Purpose of the Study:

To assess the feasibility and safety of renal artery angioplasty and stenting using a distal protection device.
To evaluate the efficacy of this technique in reducing intraprocedural atheroembolism.
To monitor the impact on blood pressure and renal function.

Main Methods:

A cohort of 28 hypertensive patients with atherosclerotic renal artery stenosis underwent angioplasty and stenting with a GuardWire temporary occlusion balloon for distal protection.

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Aspiration and analysis of generated debris were performed.

Blood pressure and serum creatinine levels were monitored pre- and post-procedure and during follow-up.

Main Results:

100% technical success rate was achieved in all 32 treated renal arteries.
Visible embolic debris was aspirated in all patients, with quantifiable particle numbers and sizes.
Mean blood pressure significantly decreased post-procedure, and serum creatinine levels showed a trend towards improvement or stabilization at 6-month follow-up.

Conclusions:

Distal balloon occlusion during renal interventions is a feasible and safe method to protect against atheroembolism.
The technique demonstrated potential benefits in blood pressure control and renal function preservation.
Further evaluation through randomized controlled trials is warranted to confirm these preliminary findings.