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Percutaneous transcatheter renal angioplasty: an endourological experience
P Puppo1, S Quattrini, P Bottino
1Department of Urology, University of Genoa, Italy.
Insights
Endourology offers lower morbidity for percutaneous transcatheter renal angioplasty (PTRA) compared to radiology, with comparable success rates for specific renal artery lesion types. PTRA requires careful patient selection and surgical support.
Area of Science:
- Urology
- Interventional Radiology
- Nephrology
Background:
- Percutaneous transcatheter renal angioplasty (PTRA) is a key intervention for renal artery stenosis.
- Comparing outcomes between endourological and radiological approaches is crucial for optimizing patient care.
Purpose of the Study:
- To review and compare the outcomes of 56 PTRA procedures performed in an endourology unit against radiological series.
- To evaluate the efficacy and safety of PTRA when performed within an endourological setting.
Main Methods:
- Retrospective review of 56 percutaneous transcatheter renal angioplasty procedures.
- Comparison of success rates and morbidity with published radiological series data.
- Analysis stratified by lesion type: fibrosclerotic, nonostial atherosclerosis, and ostial lesions.
Main Results:
- Endourological series showed lower success rates for fibrosclerotic (77% vs. 90%) and nonostial atherosclerosis (67.8% vs. 75%) lesions.
- Success rates for ostial lesions were slightly superior in the endourological series (33% vs. 20-30%).
- Morbidity was significantly lower in the endourological series (8.9% vs. 18.6%).
Conclusions:
- PTRA performed in an endourology unit demonstrates favorable morbidity outcomes compared to radiological series.
- The procedure's success rates are comparable across different lesion types, with a slight advantage for ostial lesions.
- PTRA is a procedure bridging interventional radiology and endourology, necessitating careful patient selection and available surgical support due to potential complications.
Abstract:
A series of 56 percutaneous transcatheter renal angioplasties, carried out in an endourological unit, is reviewed and compared with radiological series. The results were inferior for fibrosclerotic lesions (77 vs. 90%) and nonostial atherosclerosis (67.8 vs. 75%), but slightly superior for ostial lesions (33 vs. 20-30%) in the endourological series as compared with the radiological series. Conversely, morbidity was significantly inferior (8.9 vs. 18.6%). The endourological series compares well with the radiological series in the literature. Percutaneous transcatheter renal angioplasty should be considered a procedure belonging both to interventional radiology and to endourology. Owing to the technical difficulties and the complication rate, it should not be performed in outpatients and a surgical support team should be available in the event of a threatening renal complication.