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Coronary-like revascularization for atherosclerotic renal artery stenosis--results in 181 consecutive patients
1Klinik für Innere Medizin, Gesundheitszentrum Bitterfeld/Wolfen, 06749, Bitterfeld, Germany. ca.lanzer@kh-bitterfeld-wolfen.de
Insights
Coronary-like revascularization for atherosclerotic renal artery stenosis (ARAS) is a safe and effective treatment. This approach demonstrated high technical success rates with minimal complications in a retrospective analysis.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Nephrology
Background:
- Atherosclerotic renal artery stenosis (ARAS) is a significant cause of secondary hypertension and kidney disease.
- Revascularization aims to improve renal blood flow and preserve kidney function.
Purpose of the Study:
- To evaluate the early outcomes of a coronary-like revascularization technique for ARAS.
- To assess the technical feasibility and complication rates associated with this approach.
Main Methods:
- Retrospective analysis of 181 consecutive patients (198 lesions) treated for ARAS between 1999 and 2004.
- Coronary-like revascularization technique was employed.
- Technical success defined as residual stenosis ≤30%.
Main Results:
- High technical success rate of 98.3% for patients and 98.5% for lesions.
- No major adverse cardiac or cerebral events were observed.
- Minor local access site complications occurred in 3.9% of patients (hematoma, pseudoaneurysm).
Conclusions:
- Coronary-like revascularization is a technically feasible and safe option for treating ARAS.
- The procedure is associated with a very low rate of major complications.
Aims:
The aim of this study was to document the early outcome of coronary-like revascularization for atherosclerotic renal artery stenosis (ARAS).
Methods And Results:
A total of 181 consecutive patient, 102 men, mean age 66.1 (+/- 9.2) years and 79 females, mean age 68.4 (+/- 9.2) years and 198 lesions were treated between February 1999 and May 2004 for ARAS and retrospectively analyzed. At least one major cardiovascular risk factor was present in 179 (98.9%) patients. Pre-dilatation ARAS was 81.3+/-9.6%, 27 ARAS were 50-70% and no ARAS was <50%. 135 (68.2%) of the ARAS lesions were ostial and 63 (31.8%) were non-ostial. In 17 (9.4%) patients bilateral ARAS were present. Technical success defined as residual stenosis < or =30% was achieved in 178 (98.3%) of patients and 195 (98.5%) of lesions. In one patient (0.5%) the target ARAS could not be crossed, in two (1.1%) patients residual stenosis was >30%. No major adverse cardiac or cerebral effects were observed. In 3.9% of patients minor local complications of the access site occurred; 4 (2.2%) inguinal hematoma, 3 (1.7%) pseudoaneurysm were documented. Serum creatinine concentrations and systolic and diastolic blood pressure before and after the intervention were not statistically different.
Conclusions:
Coronary-like approach to ARAS revascularization is technically feasible and associated with a very low complication rate.
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