Search

Your search keyword '"Banyai, Martin"' showing total 79 results
Start Over Author "Banyai, Martin"
79 results on '"Banyai, Martin"'

51. Physical activity and risk of bleeding in elderly patients taking anticoagulants

Author

Frey, Pascal M, Méan, Marie, Limacher, Andreas, Jaeger, Kurt, Beer, Hans-Jürg, Frauchiger, Beat, Aschwanden, Markus, Rodondi, Nicolas, Righini, Marc, Egloff, Michael, Osterwalder, Joseph, Kucher, Nils, Angelillo-Scherrer, Anne, Husmann, Marc, Banyai, Martin, Matter, Christian M, Aujesky, Drahomir, Frey, Pascal M, Méan, Marie, Limacher, Andreas, Jaeger, Kurt, Beer, Hans-Jürg, Frauchiger, Beat, Aschwanden, Markus, Rodondi, Nicolas, Righini, Marc, Egloff, Michael, Osterwalder, Joseph, Kucher, Nils, Angelillo-Scherrer, Anne, Husmann, Marc, Banyai, Martin, Matter, Christian M, and Aujesky, Drahomir

Abstract

BACKGROUND Although the possibility of bleeding during anticoagulant treatment may limit patients from taking part in physical activity, the association between physical activity and anticoagulation-related bleeding is uncertain. OBJECTIVES To determine whether physical activity is associated with bleeding in elderly patients taking anticoagulants. PATIENTS/METHODS In a prospective multicenter cohort study of 988 patients aged ≥65 years receiving anticoagulants for venous thromboembolism, we assessed patients' self-reported physical activity level. The primary outcome was the time to a first major bleeding, defined as fatal bleeding, symptomatic bleeding in a critical site, or bleeding causing a fall in hemoglobin or leading to transfusions. The secondary outcome was the time to a first clinically-relevant non-major bleeding. We examined the association between physical activity level and time to a first bleeding using competing risk regression, accounting for death as a competing event. We adjusted for known bleeding risk factors and anticoagulation as a time-varying covariate. RESULTS During a mean follow-up of 22 months, patients with a low, moderate, and high physical activity level had an incidence of major bleeding of 11.6, 6.3, and 3.1 events per 100 patient-years, and an incidence of clinically relevant non-major bleeding of 14.0, 10.3, and 7.7 events per 100 patient-years, respectively. A high physical activity level was significantly associated with a lower risk of major bleeding (adjusted sub-hazard ratio 0.40, 95%-CI 0.22-0.72). There was no association between physical activity and non-major bleeding. CONCLUSIONS A high level of physical activity is associated with a decreased risk of major bleeding in elderly patients receiving anticoagulant therapy. This article is protected by copyright. All rights reserved.

Published
2015

52. Elevated Gas6 Plasma Level As a Predictor of Venous Thromboembolism Recurrence and Mortality in a Prospective Multicenter Cohort of Elderly Patients with Venous Thromboembolism

Author

Schnegg-Kaufmann, Annatina, Calzavarini, Sara, LImacher, Andreas, Mean, Marie, Righini, Marc, Staub, Daniel, Beer, Jürg Hans, Frauchiger, Beat, Osterwalder, Joseph, Kucher, Nils, Cornuz, Jacques, Matter, Christian M., Husmann, Marc, Banyai, Martin, Aschwanden, Markus, Mazzolai, Lucia, Hugli, Olivier, Nagler, Michael, Rodondi, Nicolas, Aujesky, Drahomir, and Angelillo-Scherrer, Anne

Published
2017
Full Text
View/download PDF

53. Polypharmacy is Associated with an Increased Risk of Bleeding in Elderly Patients with Venous Thromboembolism

Author

Leiss, Waltraud, primary, Méan, Marie, additional, Limacher, Andreas, additional, Righini, Marc, additional, Jaeger, Kurt, additional, Beer, Hans-Jürg, additional, Osterwalder, Joseph, additional, Frauchiger, Beat, additional, Matter, Christian M., additional, Kucher, Nils, additional, Angelillo-Scherrer, Anne, additional, Cornuz, Jacques, additional, Banyai, Martin, additional, Lämmle, Bernhard, additional, Husmann, Marc, additional, Egloff, Michael, additional, Aschwanden, Markus, additional, Rodondi, Nicolas, additional, and Aujesky, Drahomir, additional

Published
2014
Full Text
View/download PDF

65. MILRINONE IN PATIENTS WITH HYPODYNAMIC SIRS/SEPSIS

Author

Heinz, Gottfried, primary, Geppert, Alexander, additional, Karth, Georg Delle, additional, Reinelt, Peter, additional, Gschwandtner, Michael, additional, Neunteufl, Thomas, additional, Banyai, Martin, additional, Zauner, Christian, additional, Frossard, Martin, additional, and Siostrzonek, Peter, additional

Published
1998
Full Text
View/download PDF

70. Blood fluidity and outcome after femoropopliteal percutaneous transluminal angioplasty (PTA): Role of plasma viscosity and low platelet count in predicting restenosis.

Author

van der Loo, Bernd, Kovacevic, Tamara, Krieger, Elisabeth, Banyai, Susanne, Banyai, Martin, Amann-Vesti, Beatrice R., Jagacic, Dorijan, Rousson, Valentin, and Koppensteiner, Renate

Subjects
CORONARY restenosis, ANGIOPLASTY, BLOOD viscosity, FIBRINOGEN, HEMATOCRIT, HYPERTENSION
Abstract

Rheological abnormalities are well known in patients with peripheral arterial occlusive disease (PAOD). We wanted to determine whether rheological variables are related to restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA). In 114 patients (62 men; median age 70 years) undergoing femoropopliteal PTA for symptomatic peripheral arterial occlusive disease (PAOD) plasma viscosity, red cell aggregation, whole blood viscosity, hematocrit, fibrinogen, platelet count, leukocytes and C‐reactive protein were determined the day after the procedure and at 1, 3, and 12 months. The primary endpoint was restenosis >50% documented by duplexsonography up to 12 months. Cox proportional hazards analysis was used to assess the risk of restenosis for postinterventional values of rheological variables. Forty‐eight patients (42%) developed restenosis at 12 months. Patients with restenosis had higher baseline plasma viscosity (PV) (medians, 1.71 vs. 1.65 millipascal seconds [mPa.s]; p=0.04) and lower platelet count (224 vs. 240×103/μl; p=0.03) than patients without restenosis. The hazard ratio (HR; 95% CI) of incident restenosis was 9.2 (1.12–76; p=0.03) for PV and 0.99 (0.99–1.0; p=0.07) for PLT. When examining jointly both high PV and low platelet count (PLT), patients with PV > 1.66 mPa.s and PLT < 233×103/μl (i.e. variables split at their respective median) had an increased risk of restenosis (log‐rank test p=0.01). Multivariate Cox proportional hazard analysis showed that plasma viscosity (p=0.02), low platelet count (p=0.01), lesion length (p=0.0037) and lack of hypertension (p=0.01) were associated with restenosis at 12 months. No associations were found between restenosis and the other rheological and inflammatory variables studied. Our data suggest that increased PV and low PLT contribute to restenosis after femoropopliteal PTA. [ABSTRACT FROM AUTHOR]

Published
2005

72. Predictors and Causes of Long-Term Mortality in Elderly Patients with Acute Venous Thromboembolism: A Prospective Cohort Study

Author

Faller, Nicolas, Limacher, Andreas, Méan, Marie, Righini, Marc, Aschwanden, Markus, Beer, Jürg Hans, Frauchiger, Beat, Osterwalder, Josef, Kucher, Nils, Lämmle, Bernhard, Cornuz, Jacques, Angelillo-Scherrer, Anne, Matter, Christian M., Husmann, Marc, Banyai, Martin, Staub, Daniel, Mazzolai, Lucia, Hugli, Olivier, Rodondi, Nicolas, and Aujesky, Drahomir

Subjects
610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract

BACKGROUND: Long-term predictors and causes of death are understudied in elderly patients with acute venous thromboembolism. METHODS: We prospectively followed up 991 patients aged ≥65 years with acute venous thromboembolism in a multicenter Swiss cohort study. The primary outcome was overall mortality. We explored the association between patient baseline characteristics and mortality, adjusting for other baseline variables and periods of anticoagulation as a time-varying covariate. Causes of death over time were adjudicated by a blinded, independent committee. RESULTS: The median age was 75 years. During a median follow-up period of 30 months, 206 patients (21%) died. Independent predictors of overall mortality were age (hazard ratio [HR], 1.32; 95% confidence interval [CI], 1.05-1.65, per decade), active cancer (HR, 5.80; 95% CI, 4.22-7.97), systolic blood pressure 40 mg/L (HR, 1.88; 95% CI, 1.36-2.60), ultra-sensitive troponin >14 pg/mL (HR, 1.54; 95% CI, 1.06-2.25), and D-dimer >3000 ng/mL (HR, 1.45; 95% CI, 1.04-2.01). Cancer (34%), pulmonary embolism (18%), infection (17%), and bleeding (6%) were the most common causes of death. CONCLUSIONS: Elderly patients with acute venous thromboembolism have a substantial long-term mortality, and several factors, including polypharmacy and a low physical activity level, are associated with long-term mortality. Cancer, pulmonary embolism, infections, and bleeding are the most common causes of death in the elderly with venous thromboembolism.

73. Elevated HbA1c is not associated with recurrent venous thromboembolism in the elderly, but with all-cause mortality- the SWEETCO 65+ study

Author

Mathis, Alexandra, Villiger, Lukas, Reiner, Martin F, Egloff, Michael, Schmid, Hans Ruedi, Stivala, Simona, Limacher, Andreas, Méan, Marie, Aujesky, Drahomir, Rodondi, Nicolas, Angelillo, Anne, Righini, Marc, Staub, Daniel, Aschwanden, Markus, Frauchiger, Beat, Osterwalder, Joseph, Kucher, Nils, Matter, Christian M, Banyai, Martin, Hugli, Oliver, and Beer, Juerg H

Subjects
endocrine system diseases, 610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract

The association of glycated hemoglobin (HbA1c) with venous thromboembolism (VTE) and death in the elderly is unknown. In the SWEETCO 65+ study we analyzed prospectively a Swiss Cohort of Elderly Patients with Venous Thromboembolism (SWITCO 65+). 888 patients were enrolled for the SWEETCO 65+ analysis. HbA1c was determined at baseline and divided into three categories (HbA1c 6.5%, diabetic range). Median follow-up was 2.5 years. The primary endpoint was recurrent VTE. Secondary endpoints included all-cause mortality and major bleeds. The total prevalence of diabetes was 22.1%. The risk of recurrent VTE was similar in patients with HbA1c with pre-diabetes (adjusted subhazard ratio (aSHR) 1.07 [0.70 to 1.63]) and diabetes (aSHR 0.73 [0.39 to 1.37]) as compared to those with a HbA1c in the normal range. However, a HbA1c ≥ 6.5% (median IQ range 7.0 [6.70;7.60]) was significantly associated with a higher risk of all-cause mortality (adjusted hazard ratio [aHR] 1.83 [1.21 to 2.75]). In summary we found no association between HbA1c and major bleeding. Elevated HbA1c levels are not associated with recurrent VTE but with increased all-cause mortality in an elderly population with acute VTE.

74. Anticoagulation Management Practices and Outcomes in Elderly Patients with Acute Venous Thromboembolism: A Clinical Research Study

Author

Staub, Daniel, Aschwanden, Markus, Rodondi, Nicolas, Osterwalder, Joseph, Limacher, Andreas, Aujesky, Drahomir, Insam, Charlène Johanna, Lämmle, Bernhard, Frauchiger, Beat, Beer, Juerg-Hans, Méan Pascual, Marie, Banyai, Martin, Husmann, Marc, Matter, Christian, Angelillo, Anne, Bounameaux, Henri, Egloff, Michael, Righini, Marc, and Kucher, Nils

Subjects
610 Medicine & health, 360 Social problems & social services, 3. Good health
Abstract

Whether anticoagulation management practices are associated with improved outcomes in elderly patients with acute venous thromboembolism (VTE) is uncertain. Thus, we aimed to examine whether practices recommended by the American College of Chest Physicians guidelines are associated with outcomes in elderly patients with VTE. We studied 991 patients aged ≥65 years with acute VTE in a Swiss prospective multicenter cohort study and assessed the adherence to four management practices: parenteral anticoagulation ≥5 days, INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulation, early start with vitamin K antagonists (VKA) ≤24 hours of VTE diagnosis, and the use of low-molecular-weight heparin (LMWH) or fondaparinux. The outcomes were all-cause mortality, VTE recurrence, and major bleeding at 6 months, and the length of hospital stay (LOS). We used Cox regression and lognormal survival models, adjusting for patient characteristics. Overall, 9% of patients died, 3% had VTE recurrence, and 7% major bleeding. Early start with VKA was associated with a lower risk of major bleeding (adjusted hazard ratio 0.37, 95% CI 0.20-0.71). Early start with VKA (adjusted time ratio [TR] 0.77, 95% CI 0.69-0.86) and use of LMWH/fondaparinux (adjusted TR 0.87, 95% CI 0.78-0.97) were associated with a shorter LOS. An INR ≥2.0 for ≥24 hours before stopping parenteral anticoagulants was associated with a longer LOS (adjusted TR 1.2, 95% CI 1.08-1.33). In elderly patients with VTE, the adherence to recommended anticoagulation management practices showed mixed results. In conclusion, only early start with VKA and use of parenteral LMWH/fondaparinux were associated with better outcomes.

75. Polypharmacy is Associated with an Increased Risk of Bleeding in Elderly Patients with Venous Thromboembolism

Author

Husmann, Marc, Osterwalder, Joseph, Righini, Marc, Angelillo, Anne, Aschwanden, Markus, Lämmle, Bernhard, Jaeger, Kurt, Banyai, Martin, Limacher, Andreas, Frauchiger, Beat, Méan, Marie, Kucher, Nils, Egloff, Michael, Aujesky, Drahomir, Matter, Christian M, Leiss, Waltraud, Beer, Hans-Jürg, Cornuz, Jacques, and Rodondi, Nicolas

Subjects
610 Medicine & health, 3. Good health
Abstract

BACKGROUND Polypharmacy, defined as the concomitant use of multiple medications, is very common in the elderly and may trigger drug-drug interactions and increase the risk of falls in patients receiving vitamin K antagonists. OBJECTIVE To examine whether polypharmacy increases the risk of bleeding in elderly patients who receive vitamin K antagonists for acute venous thromboembolism (VTE). DESIGN We used a prospective cohort study. PARTICIPANTS In a multicenter Swiss cohort, we studied 830 patients aged ≥ 65 years with VTE. MAIN MEASURES We defined polypharmacy as the prescription of more than four different drugs. We assessed the association between polypharmacy and the time to a first major and clinically relevant non-major bleeding, accounting for the competing risk of death. We adjusted for known bleeding risk factors (age, gender, pulmonary embolism, active cancer, arterial hypertension, cardiac disease, cerebrovascular disease, chronic liver and renal disease, diabetes mellitus, history of major bleeding, recent surgery, anemia, thrombocytopenia) and periods of vitamin K antagonist treatment as a time-varying covariate. KEY RESULTS Overall, 413 (49.8 %) patients had polypharmacy. The mean follow-up duration was 17.8 months. Patients with polypharmacy had a significantly higher incidence of major (9.0 vs. 4.1 events/100 patient-years; incidence rate ratio [IRR] 2.18, 95 % confidence interval [CI] 1.32-3.68) and clinically relevant non-major bleeding (14.8 vs. 8.0 events/100 patient-years; IRR 1.85, 95 % CI 1.27-2.71) than patients without polypharmacy. After adjustment, polypharmacy was significantly associated with major (sub-hazard ratio [SHR] 1.83, 95 % CI 1.03-3.25) and clinically relevant non-major bleeding (SHR 1.60, 95 % CI 1.06-2.42). CONCLUSIONS Polypharmacy is associated with an increased risk of both major and clinically relevant non-major bleeding in elderly patients receiving vitamin K antagonists for VTE.

76. Polypharmacy is Associated with an Increased Risk of Bleeding in Elderly Patients with Venous Thromboembolism

Author

Leiss, Waltraud, Méan, Marie, Limacher, Andreas, Righini, Marc, Jaeger, Kurt, Beer, Hans-Jürg, Osterwalder, Joseph, Frauchiger, Beat, Matter, Christian, Kucher, Nils, Angelillo-Scherrer, Anne, Cornuz, Jacques, Banyai, Martin, Lämmle, Bernhard, Husmann, Marc, Egloff, Michael, Aschwanden, Markus, Rodondi, Nicolas, Aujesky, Drahomir, Leiss, Waltraud, Méan, Marie, Limacher, Andreas, Righini, Marc, Jaeger, Kurt, Beer, Hans-Jürg, Osterwalder, Joseph, Frauchiger, Beat, Matter, Christian, Kucher, Nils, Angelillo-Scherrer, Anne, Cornuz, Jacques, Banyai, Martin, Lämmle, Bernhard, Husmann, Marc, Egloff, Michael, Aschwanden, Markus, Rodondi, Nicolas, and Aujesky, Drahomir

Abstract

BACKGROUND: Polypharmacy, defined as the concomitant use of multiple medications, is very common in the elderly and may trigger drug-drug interactions and increase the risk of falls in patients receiving vitamin K antagonists. OBJECTIVE: To examine whether polypharmacy increases the risk of bleeding in elderly patients who receive vitamin K antagonists for acute venous thromboembolism (VTE). DESIGN: We used a prospective cohort study. PARTICIPANTS: In a multicenter Swiss cohort, we studied 830 patients aged ≥ 65years with VTE. MAIN MEASURES: We defined polypharmacy as the prescription of more than four different drugs. We assessed the association between polypharmacy and the time to a first major and clinically relevant non-major bleeding, accounting for the competing risk of death. We adjusted for known bleeding risk factors (age, gender, pulmonary embolism, active cancer, arterial hypertension, cardiac disease, cerebrovascular disease, chronic liver and renal disease, diabetes mellitus, history of major bleeding, recent surgery, anemia, thrombocytopenia) and periods of vitamin K antagonist treatment as a time-varying covariate. KEY RESULTS: Overall, 413 (49.8%) patients had polypharmacy. The mean follow-up duration was 17.8months. Patients with polypharmacy had a significantly higher incidence of major (9.0 vs. 4.1 events/100 patient-years; incidence rate ratio [IRR] 2.18, 95% confidence interval [CI] 1.32-3.68) and clinically relevant non-major bleeding (14.8 vs. 8.0 events/100 patient-years; IRR 1.85, 95% CI 1.27-2.71) than patients without polypharmacy. After adjustment, polypharmacy was significantly associated with major (sub-hazard ratio [SHR] 1.83, 95% CI 1.03-3.25) and clinically relevant non-major bleeding (SHR 1.60, 95% CI 1.06-2.42). CONCLUSIONS: Polypharmacy is associated with an increased risk of both major and clinically relevant non-major bleeding in elderly patients receiving vitamin K antagonists for VTE.

77. The Swiss cohort of elderly patients with venous thromboembolism (SWITCO65+): rationale and methodology

Author

Méan, Marie, Righini, Marc, Jaeger, Kurt, Beer, Hans-Jürg, Frauchiger, Beat, Osterwalder, Joseph, Kucher, Nils, Lämmle, Bernhard, Cornuz, Jacques, Angelillo-Scherrer, Anne, Rodondi, Nicolas, Limacher, Andreas, Trelle, Sven, Matter, Christian, Husmann, Marc, Banyai, Martin, Aschwanden, Markus, Egloff, Michael, Mazzolai, Lucia, Hugli, Olivier, Bounameaux, Henri, Aujesky, Drahomir, Méan, Marie, Righini, Marc, Jaeger, Kurt, Beer, Hans-Jürg, Frauchiger, Beat, Osterwalder, Joseph, Kucher, Nils, Lämmle, Bernhard, Cornuz, Jacques, Angelillo-Scherrer, Anne, Rodondi, Nicolas, Limacher, Andreas, Trelle, Sven, Matter, Christian, Husmann, Marc, Banyai, Martin, Aschwanden, Markus, Egloff, Michael, Mazzolai, Lucia, Hugli, Olivier, Bounameaux, Henri, and Aujesky, Drahomir

Abstract

Venous thromboembolism (VTE) is common and has a high impact on morbidity, mortality, and costs of care. Although most of the patients with VTE are aged ≥65years, there is little data about the medical outcomes in the elderly with VTE. The Swiss Cohort of Elderly Patients with VTE (SWITCO65+) is a prospective multicenter cohort study of in- and outpatients aged ≥65years with acute VTE from all five Swiss university and four high-volume non-university hospitals. The goal is to examine which clinical and biological factors and processes of care drive short- and long-term medical outcomes, health-related quality of life, and medical resource utilization in elderly patients with acute VTE. The cohort also includes a large biobank with biological material from each participant. From September 2009 to March 2012, 1,863 elderly patients with VTE were screened and 1003 (53.8%) were enrolled in the cohort. Overall, 51.7% of patients were aged ≥75years and 52.7% were men. By October 16, 2012, after an average follow-up time of 512days, 799 (79.7%) patients were still actively participating. SWITCO65+ is a unique opportunity to study short- and long-term outcomes in elderly patients with VTE. The Steering Committee encourages national and international collaborative research projects related to SWITCO65+, including sharing anonymized data and biological samples

78. The IN.PACT DEEP Clinical Drug-Coated Balloon Trial: 5-Year Outcomes.

Author

Zeller T, Micari A, Scheinert D, Baumgartner I, Bosiers M, Vermassen FEG, Banyai M, Shishehbor MH, Wang H, and Brodmann M

Subjects
Aged, Aged, 80 and over, Amputation, Surgical, Angioplasty, Balloon adverse effects, Angioplasty, Balloon mortality, Cardiovascular Agents adverse effects, Critical Illness, Equipment Design, Europe, Female, Humans, Ischemia diagnostic imaging, Ischemia mortality, Ischemia physiopathology, Limb Salvage, Male, Middle Aged, Paclitaxel adverse effects, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease mortality, Peripheral Arterial Disease physiopathology, Prospective Studies, Recurrence, Risk Factors, Time Factors, Treatment Outcome, Vascular Patency, Angioplasty, Balloon instrumentation, Cardiovascular Agents administration & dosage, Coated Materials, Biocompatible, Ischemia therapy, Paclitaxel administration & dosage, Peripheral Arterial Disease therapy
Abstract

Objectives: The goal of this study was to evaluate the 5-year follow-up data of the IN.PACT DEEP (Randomized IN.PACT Amphirion Drug-Coated Balloon [DCB] vs. Standard Percutaneous Transluminal Angioplasty [PTA] for the Treatment of Below-the-Knee Critical Limb Ischemia [CLI]) trial., Background: Initial studies from randomized controlled trials have shown comparable short-term outcomes of DCB angioplasty versus PTA in patients with CLI with infrapopliteal disease. However, the long-term safety and effectiveness of DCB angioplasty remain unknown in this patient population., Methods: IN.PACT DEEP was an independently adjudicated prospective, multicenter, randomized controlled trial that enrolled 358 subjects with CLI. Subjects were randomized 2:1 to DCB angioplasty or PTA. Assessments through 5 years included freedom from clinically driven target lesion revascularization, amputation, and all-cause death. Additional assessments were conducted to identify risk factors for death and major amputation, including paclitaxel dose tercile., Results: Freedom from clinically driven target lesion revascularization through 5 years was 70.9% and 76.0% (log-rank p = 0.406), and the incidence of the safety composite endpoint was 59.8% and 57.5% (log-rank p = 0.309) in the DCB angioplasty and PTA groups, respectively. The rate of major amputation was 15.4% for DCB angioplasty compared with 10.6% for PTA (log-rank p = 0.108). Given the recent concern regarding a late mortality signal in patients treated with paclitaxel-coated devices, additional analyses from this study showed no increase in all-cause mortality with DCB angioplasty (39.4%) compared with PTA (44.9%) (log-rank p = 0.727). Predictors of mortality included age, Rutherford category >4, and previous revascularization but not paclitaxel by dose tercile., Conclusions: Tibial artery revascularization in patients with CLI using DCB angioplasty resulted in comparable long-term safety and effectiveness as PTA. Paclitaxel exposure was not related to increased risk for amputation or all-cause mortality at 5-year follow-up. (Study of IN.PACT Amphirion™ Drug Eluting Balloon vs. Standard PTA for the Treatment of Below the Knee Critical Limb Ischemia [INPACT-DEEP]; NCT00941733)., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Published
2020
Full Text
View/download PDF

79. Renal artery PTA and stent implantation: immediate and late clinical and morphological outcome.

Author

Ahmadi R, Schillinger M, Sabeti S, Loewe C, Mlekusch W, Haumer M, Banyai M, Lammer J, and Minar E

Subjects
Aged, Angiography, Cohort Studies, Female, Finland, Follow-Up Studies, Humans, Hypertension, Renovascular diagnosis, Kidney Function Tests, Male, Middle Aged, Recurrence, Renal Artery Obstruction diagnosis, Retreatment, Retrospective Studies, Tomography, Spiral Computed, Treatment Outcome, Angioplasty, Balloon adverse effects, Hypertension, Renovascular therapy, Renal Artery Obstruction therapy, Stents adverse effects
Abstract

Background: Renal artery stenosis (RAS) is a potentially curable cause of secondary hypertension, but the indications for interventional treatment of renovascular hypertension are still a matter of debate. The aim of the study was to investigate immediate and long-term results of percutaneous renal artery revascularization (PTRA). Primary technical success, peri-intervention complications, patency, the course of arterial hypertension and renal function were analyzed., Methods: 32 renal interventions in 24 consecutive patients (15 PTA, 17 stents) were investigated in a retrospective cohort study. Comorbidities, interventional data and serum creatinine were recorded. Patients were followed for a median period of 45 months (IQR, 32 to 68). Clinical evaluation of the course of blood pressure, serum creatinine, Doppler ultrasound evaluation and multi-slice spiral-CT angiography were performed at follow-up., Results: Primary technical success was achieved in 30 interventions (94%), and in 2 patients during a secondary intervention. The rate of complications was 16% (n = 5). Three major complications were encountered (9%): 1 renal artery thrombosis and 2 acute renal failures. Three patients developed late renal failure after 1, 4 and 37 months, but the overall serum creatinine levels remained stable during the observation period. Hypertension was improved after intervention in 17 patients (71%). However, recurrent hypertension was found in 9 patients (38%) after a median period of 49 months (IQR, 47 to 96). Patency rates at 12, 24 and 72 months were 94%, 94% and 64%, respectively., Conclusion: Renal artery PTA can be performed with an acceptable rate of major complications and good long term morphological results. However, clinical outcome in terms of sustained improvement of hypertension is moderate.

Published
2002

Catalog

Books, media, physical & digital resources
See catalog results