Preliminary experience in endovascular management of renal artery stenosis

ABSTRACT

From June 1997 to March 2001, 22 patients [14 males and 8 females with mean age 45.2 years] underwent 28 percutaneous transluminal renal angioplasties [PTRA] and stenting. Stenting was done in 13 cases only [direct stenting in five of them]. Fifteen patients underwent treatment for renovascular hypertension, 5 patients for renal impairment and only 2 cases to prevent kidney loss from change of renal artery stenosis to total occlusion. Femoral approach was used in 20 cases and brachial approach was used in 2 cases only. Complications occurred in 5 cases included hematoma at the puncture site in one case, perinephric hematoma in one case, deterioration in kidney function in one, acute renal thrombosis in one and death due to massive myocardial infraction in one case. Renovascular hypertension was cured in 5 cases, improved in 7 cases, no change in 2 cases and became more worse in one case. Regular clinical, laboratory investigations and duplex follow up was done on all patients for a period between 3 months and 24 months [average 18 months]. Restenosis occurred in 4 cases. Another PTRA and stenting was done in 3 cases. Nonsignificant stenosis occurred in one case and needed only follow-up