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J Vasc Interv Radiol ; 25(4): 511-20, 2014 Apr.
Article in English | MEDLINE | ID: mdl-24325931

ABSTRACT

PURPOSE: To describe the experience and results from the roll-in phase of the Cardiovascular Outcomes with Renal Atherosclerotic Lesions (CORAL) study. MATERIALS AND METHODS: The CORAL roll-in database was used to describe the baseline characteristics of the patients in the roll-in cohort, all of whom underwent renal artery stent placement; to evaluate CORAL site performance; to compare estimates of lesion (stenosis) severity made by site interventionalists with the central CORAL angiographic core laboratory readings; and to report outcomes after renal artery stent placement. During the roll-in phase, 239 patients (mean age, 70.2 y ± 9.0; 49% male) underwent renal artery stent procedures. Angiographic core laboratory analysis of renal arteriograms was done, and participants were followed at 1 month and 9 months. RESULTS: Major angiographic complications were identified in 28 (13%) subjects. Kidney function remained unchanged at the short (2-4 weeks) follow-up interval. Improvement in systolic blood pressure with use of distal embolic protection devices (n = 161) did not show any clinical benefit over nonuse of such devices (n = 78) in this small series. At 9 months, there were significantly more endpoints reported by site in subjects with bilateral renal artery stenosis (P = .01) and prior history of stroke (P = .03). CONCLUSIONS: In the roll-in phase of the CORAL study, a significant number of angiographic complications were identified. No effect was seen on estimated glomerular filtration rate after renal artery stent placement, but systolic blood pressure decreased significantly.


Subject(s)
Angioplasty, Balloon , Atherosclerosis/therapy , Outcome and Process Assessment, Health Care , Renal Artery Obstruction/therapy , Adult , Aged , Aged, 80 and over , Angioplasty, Balloon/adverse effects , Angioplasty, Balloon/instrumentation , Atherosclerosis/diagnosis , Atherosclerosis/physiopathology , Blood Pressure , Clinical Competence , Databases, Factual , Female , Glomerular Filtration Rate , Humans , Hypertension/diagnosis , Hypertension/physiopathology , Hypertension/therapy , Kidney/physiopathology , Male , Middle Aged , Patient Selection , Renal Artery Obstruction/diagnosis , Renal Artery Obstruction/physiopathology , Renal Insufficiency, Chronic/diagnosis , Renal Insufficiency, Chronic/physiopathology , Renal Insufficiency, Chronic/therapy , Severity of Illness Index , Stents , Time Factors , Treatment Outcome
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