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Embolic protection for renal artery stenting
M Henry1, I Henry, A Polydorou
1Cardiology Practice, 80 rue Raymond Poincaré, Nancy, France, m.henryilrmdt@wanadoo.fr
The Journal of Cardiovascular Surgery
|August 2, 2008
Summary
Renal embolic protection devices significantly reduce post-procedure renal function deterioration in atherosclerotic renal artery stenosis patients undergoing percutaneous renal artery angioplasty and stenting. This technique is safe and effective, stabilizing or improving renal function in 99% of patients.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Interventional Cardiology
Background:
- Renal artery stenosis (RAS) is frequently caused by atherosclerosis.
- Percutaneous renal artery angioplasty and stenting (PTRA) offers good short- and long-term outcomes.
- Postprocedural renal function deterioration occurs in 20-40% of patients, limiting PTRA benefits.
Purpose of the Study:
- To evaluate the efficacy of renal embolic protection devices in preventing atheroembolism.
- To assess the impact of embolic protection on renal function deterioration after PTRA.
- To determine the safety and feasibility of using distal protection during renal interventions.
Main Methods:
- 148 PTRA and stenting procedures were performed with embolic protection (occlusion balloons or filters) in 121 hypertensive patients with atherosclerotic RAS.
- The FiberNet EP system was utilized, designed to capture particles as small as 30-40 microns.
- Debris was analyzed, and blood pressure and serum creatinine levels were monitored.
Main Results:
- Immediate technical success was 100%.
- One acute renal function deterioration was observed in the entire cohort.
- At 6 months, 99% of patients were stabilized or improved; at 2 years, 95% remained stable or improved.
Conclusions:
- Distal embolic protection is feasible and safe during renal interventions.
- This technique effectively protects against atheroembolism and subsequent renal function decline.
- Further randomized studies are warranted to confirm the beneficial effects.
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