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Spontaneous renal artery dissection: long-term outcomes after endovascular stent placement
Olivier Pellerin1, Philippe Garçon, Bernard Beyssen
1Cardiovascular and Interventional Radiology Department, Georges Pompidou European Hospital, Paris 5, René Descartes University, 20 rue Leblanc, Paris Cedex 15, France. olivier.pellerin@egp.aphp.fr
Insights
Stent placement effectively treats spontaneous renal artery dissection (SRAD), improving blood pressure and kidney function long-term. This safe procedure offers a viable alternative to surgery for SRAD patients.
Area of Science:
- Interventional Cardiology
- Vascular Surgery
- Nephrology
Background:
- Spontaneous renal artery dissection (SRAD) often presents with uncontrolled hypertension and potential renal insufficiency.
- Early diagnosis and intervention are crucial for managing SRAD and preserving kidney function.
Purpose of the Study:
- To evaluate the long-term clinical and morphological outcomes of stent placement in patients with spontaneous renal artery dissection.
- To assess the efficacy and safety of endovascular stenting as a treatment for SRAD.
Main Methods:
- Retrospective analysis of 16 consecutive patients (17 arteries) treated for SRAD between 1991 and 2006.
- All patients underwent renal angiography followed by successful renal artery stent implantation.
- Long-term follow-up included clinical assessment and renal imaging to monitor for restenosis or occlusion.
Main Results:
- Successful renal artery recanalization and stent implantation were achieved in all patients.
- Mean follow-up of 8.6 years showed significant reduction in blood pressure (176/107 to 118/78 mm Hg).
- All patients demonstrated normal plasma creatinine levels, and imaging revealed no restenosis or occlusion.
Conclusions:
- Renal artery stenting is a highly effective long-term treatment for symptomatic spontaneous renal artery dissection.
- Stent implantation provides a safe and durable alternative to surgical intervention for SRAD.
Purpose:
To report long-term clinical and morphologic results after stent placement for spontaneous renal artery dissection (SRAD).
Materials And Methods:
Between 1991 and 2006, 16 consecutive patients (13 men; mean age, 42 y +/- 12) presented with SRAD in 17 arteries. All patients had uncontrolled hypertension at the time of presentation. Nine patients had lower back pain, 10 had progressive renal insufficiency, and three had both. All patients underwent renal angiography and stent implantation. They were followed up clinically and with renal imaging.
Results:
Baseline blood pressure and plasma creatinine levels were 176/107 mm Hg and 142 micromol/L, respectively. Successful renal artery recanalization and stent implantation were achieved in all patients. After a mean follow-up of 8.6 years +/- 3.4, mean blood pressure was 118/78 mm Hg, with Seven patients were taking no antihypertensive medication, with five and four patients taking single or double antihypertensive agents, respectively. The most recent follow-up showed that plasma creatinine levels were normal, and imaging of the renal arteries showed no sign of restenosis or occlusion in all patients.
Conclusions:
Stent implantation for symptomatic SRAD is an effective treatment in the long term and represents a safe alternative to surgery.
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