Outcomes of renal artery angioplasty and stenting using low-profile systems
Renal artery percutaneous transluminal angioplasty (RPTA) and stenting (RAS) are accepted therapies for selected patients with renovascular hypertension and chronic renal insufficiency. We evaluated the outcomes and complications of RAS performed by vascular surgeons at our institution with modern l...
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| Veröffentlicht in: | Journal of vascular surgery 2005, Vol.41 (1), p.46-52 |
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| creator | Nolan, Brian W. Schermerhorn, Marc L. Rowell, Erin Powell, Richard J. Fillinger, Mark F. Rzucidlo, Eva M. Wyers, Mark C. Zwolak, Robert M. Walsh, Daniel B. Cronenwett, Jack L. |
| description | Renal artery percutaneous transluminal angioplasty (RPTA) and stenting (RAS) are accepted therapies for selected patients with renovascular hypertension and chronic renal insufficiency. We evaluated the outcomes and complications of RAS performed by vascular surgeons at our institution with modern low-profile systems.
We retrospectively analyzed all RPTA and RAS procedures attempted with the use of low-profile systems from June 2000 to September 2003. Eighty-two patients (96 arteries) with atherosclerotic renal artery stenosis were treated. Indication for treatment was hypertension in 44 (54%) and chronic renal insufficiency in 38 (46%). Technical success, complication rates, clinical success for control of hypertension or renal insufficiency, restenosis, and survival were reviewed with a mean follow-up of 1 year.
Ninety-three arteries were treated with stents, three with RPTA only. Primary technical success was 95%, with 98% overall technical success. Major complications occurred in 6.1% and minor complications in 1.2%. Hypertension was improved in 81% at 1 year. Renal function was improved in 23%, stable in 53%, and worse in 24% at 1 year. Restenosis was seen by routine duplex surveillance in 25% at 1 year. Restenosis associated with clinical deterioration and confirmed by angiogram was seen in 10%. The overall 3-year survival was 83%.
RPTA/RAS can be performed with low-profile systems with excellent technical success, low complication rates, and clinical outcomes that compare favorably with prior reports. |
| doi_str_mv | 10.1016/j.jvs.2004.10.027 |
| format | Article |
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We retrospectively analyzed all RPTA and RAS procedures attempted with the use of low-profile systems from June 2000 to September 2003. Eighty-two patients (96 arteries) with atherosclerotic renal artery stenosis were treated. Indication for treatment was hypertension in 44 (54%) and chronic renal insufficiency in 38 (46%). Technical success, complication rates, clinical success for control of hypertension or renal insufficiency, restenosis, and survival were reviewed with a mean follow-up of 1 year.
Ninety-three arteries were treated with stents, three with RPTA only. Primary technical success was 95%, with 98% overall technical success. Major complications occurred in 6.1% and minor complications in 1.2%. Hypertension was improved in 81% at 1 year. Renal function was improved in 23%, stable in 53%, and worse in 24% at 1 year. Restenosis was seen by routine duplex surveillance in 25% at 1 year. Restenosis associated with clinical deterioration and confirmed by angiogram was seen in 10%. The overall 3-year survival was 83%.
RPTA/RAS can be performed with low-profile systems with excellent technical success, low complication rates, and clinical outcomes that compare favorably with prior reports.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2004.10.027</identifier><identifier>PMID: 15696043</identifier><identifier>CODEN: JVSUES</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Angioplasty, Balloon ; Arteriosclerosis - therapy ; Biological and medical sciences ; Diseases of the cardiovascular system ; Female ; Humans ; Hypertension, Renovascular - therapy ; Kidney Failure, Chronic - therapy ; Male ; Medical sciences ; Middle Aged ; Postoperative Complications ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Recurrence ; Renal Artery - surgery ; Renal Artery Obstruction - therapy ; Retrospective Studies ; Stents ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Time Factors ; Treatment Outcome ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>Journal of vascular surgery, 2005, Vol.41 (1), p.46-52</ispartof><rights>2005 The Society for Vascular Surgery</rights><rights>2005 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-457f1227d92b6486282c22a07b65191bff7559ad226b8005d3f32393c6f923fd3</citedby><cites>FETCH-LOGICAL-c424t-457f1227d92b6486282c22a07b65191bff7559ad226b8005d3f32393c6f923fd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2004.10.027$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,4025,27928,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16531417$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15696043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nolan, Brian W.</creatorcontrib><creatorcontrib>Schermerhorn, Marc L.</creatorcontrib><creatorcontrib>Rowell, Erin</creatorcontrib><creatorcontrib>Powell, Richard J.</creatorcontrib><creatorcontrib>Fillinger, Mark F.</creatorcontrib><creatorcontrib>Rzucidlo, Eva M.</creatorcontrib><creatorcontrib>Wyers, Mark C.</creatorcontrib><creatorcontrib>Zwolak, Robert M.</creatorcontrib><creatorcontrib>Walsh, Daniel B.</creatorcontrib><creatorcontrib>Cronenwett, Jack L.</creatorcontrib><title>Outcomes of renal artery angioplasty and stenting using low-profile systems</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Renal artery percutaneous transluminal angioplasty (RPTA) and stenting (RAS) are accepted therapies for selected patients with renovascular hypertension and chronic renal insufficiency. We evaluated the outcomes and complications of RAS performed by vascular surgeons at our institution with modern low-profile systems.
We retrospectively analyzed all RPTA and RAS procedures attempted with the use of low-profile systems from June 2000 to September 2003. Eighty-two patients (96 arteries) with atherosclerotic renal artery stenosis were treated. Indication for treatment was hypertension in 44 (54%) and chronic renal insufficiency in 38 (46%). Technical success, complication rates, clinical success for control of hypertension or renal insufficiency, restenosis, and survival were reviewed with a mean follow-up of 1 year.
Ninety-three arteries were treated with stents, three with RPTA only. Primary technical success was 95%, with 98% overall technical success. Major complications occurred in 6.1% and minor complications in 1.2%. Hypertension was improved in 81% at 1 year. Renal function was improved in 23%, stable in 53%, and worse in 24% at 1 year. Restenosis was seen by routine duplex surveillance in 25% at 1 year. Restenosis associated with clinical deterioration and confirmed by angiogram was seen in 10%. The overall 3-year survival was 83%.
RPTA/RAS can be performed with low-profile systems with excellent technical success, low complication rates, and clinical outcomes that compare favorably with prior reports.</description><subject>Angioplasty, Balloon</subject><subject>Arteriosclerosis - therapy</subject><subject>Biological and medical sciences</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Renovascular - therapy</subject><subject>Kidney Failure, Chronic - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Recurrence</subject><subject>Renal Artery - surgery</subject><subject>Renal Artery Obstruction - therapy</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular surgery: aorta, extremities, vena cava. 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Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Recurrence</topic><topic>Renal Artery - surgery</topic><topic>Renal Artery Obstruction - therapy</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nolan, Brian W.</creatorcontrib><creatorcontrib>Schermerhorn, Marc L.</creatorcontrib><creatorcontrib>Rowell, Erin</creatorcontrib><creatorcontrib>Powell, Richard J.</creatorcontrib><creatorcontrib>Fillinger, Mark F.</creatorcontrib><creatorcontrib>Rzucidlo, Eva M.</creatorcontrib><creatorcontrib>Wyers, Mark C.</creatorcontrib><creatorcontrib>Zwolak, Robert M.</creatorcontrib><creatorcontrib>Walsh, Daniel B.</creatorcontrib><creatorcontrib>Cronenwett, Jack L.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nolan, Brian W.</au><au>Schermerhorn, Marc L.</au><au>Rowell, Erin</au><au>Powell, Richard J.</au><au>Fillinger, Mark F.</au><au>Rzucidlo, Eva M.</au><au>Wyers, Mark C.</au><au>Zwolak, Robert M.</au><au>Walsh, Daniel B.</au><au>Cronenwett, Jack L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of renal artery angioplasty and stenting using low-profile systems</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2005</date><risdate>2005</risdate><volume>41</volume><issue>1</issue><spage>46</spage><epage>52</epage><pages>46-52</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Renal artery percutaneous transluminal angioplasty (RPTA) and stenting (RAS) are accepted therapies for selected patients with renovascular hypertension and chronic renal insufficiency. We evaluated the outcomes and complications of RAS performed by vascular surgeons at our institution with modern low-profile systems.
We retrospectively analyzed all RPTA and RAS procedures attempted with the use of low-profile systems from June 2000 to September 2003. Eighty-two patients (96 arteries) with atherosclerotic renal artery stenosis were treated. Indication for treatment was hypertension in 44 (54%) and chronic renal insufficiency in 38 (46%). Technical success, complication rates, clinical success for control of hypertension or renal insufficiency, restenosis, and survival were reviewed with a mean follow-up of 1 year.
Ninety-three arteries were treated with stents, three with RPTA only. Primary technical success was 95%, with 98% overall technical success. Major complications occurred in 6.1% and minor complications in 1.2%. Hypertension was improved in 81% at 1 year. Renal function was improved in 23%, stable in 53%, and worse in 24% at 1 year. Restenosis was seen by routine duplex surveillance in 25% at 1 year. Restenosis associated with clinical deterioration and confirmed by angiogram was seen in 10%. The overall 3-year survival was 83%.
RPTA/RAS can be performed with low-profile systems with excellent technical success, low complication rates, and clinical outcomes that compare favorably with prior reports.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>15696043</pmid><doi>10.1016/j.jvs.2004.10.027</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of vascular surgery, 2005, Vol.41 (1), p.46-52 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Access via ScienceDirect (Elsevier) |
| subjects | Angioplasty, Balloon Arteriosclerosis - therapy Biological and medical sciences Diseases of the cardiovascular system Female Humans Hypertension, Renovascular - therapy Kidney Failure, Chronic - therapy Male Medical sciences Middle Aged Postoperative Complications Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Recurrence Renal Artery - surgery Renal Artery Obstruction - therapy Retrospective Studies Stents Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Time Factors Treatment Outcome Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Outcomes of renal artery angioplasty and stenting using low-profile systems |
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