Renal artery stent placement: complications at a single tertiary care center

To describe complications after renal artery stent placement in patients with atherosclerotic renal artery stenosis (RAS) at a single tertiary care center and analyze the risk factors for these complications.

Medical records and angiograms of 171 patients who underwent a total of 179 consecutive percutaneous transluminal renal artery stent placement (PTRS) procedures for atherosclerotic RAS were retrospectively reviewed. Data on patient comorbidities, procedure indication, lesion location, serum creatinine level, and procedure-related complications were analyzed. The Wilcoxon rank-sum test was used to assess the association of continuous risk factors with complications, and the chi(2) test was used to assess the association of categoric risk factors with outcomes.

The technical success rate for PTRS was 98%. Major complications included renal infarction in five patients (2.8%), permanently increased serum creatinine level in 10 patients (5.6%) that required hemodialysis in five (2.8%), blood transfusion in four patients (2.2%), surgical intervention for procedure-related complications in two patients (1.1%), and deep vein thrombosis in one patient (0.6%). Overall, major complications occurred in 15 procedures (8.4%). Death within 30 days after PTRS occurred in two patients (1.1%), but neither death was definitively caused by the procedure. No risk factors were found to be significantly (P <.05) associated with major complications. Patients with renal artery site or renal function complications tended to be older (P =.01) and have higher creatinine levels (P =.06).

Renal artery stent placement allows treatment of advanced atheromatous RAS in patients with significant medical and surgical comorbidities. Complications are frequent but few have long-term significance.