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Renal artery stent revascularization with embolic protection in patients with ischemic nephropathy
- Source :
- Kidney international. 70(5)
- Publication Year :
- 2006
-
Abstract
- A prospective analysis of renal artery stent revascularization with distal embolic protection in a high-risk patient population with ischemic nephropathy is presented. A total of 63 patients (median age 70.2 years, range 54–86 years) had significant atherosclerotic stenosis of 83 renal arteries documented on pre-procedural imaging. All patients had baseline chronic renal insufficiency with a documented deterioration in renal function in the 6 months before revascularization. The endovascular technique used in all patients involved primary passage of an embolic filter into the distal main renal artery followed by primary stent deployment with a balloon expandable stainless steel stent. The filter baskets were recaptured and contents submitted for pathological analysis. At 6 months post-intervention, 97% of patients demonstrated stabilization or improvement in renal function. Only 3% of patients had an inexorable decline in renal function, unchanged by the intervention. After a mean follow up of 16.0 months (6–27), 94% of patients demonstrated stabilization or improvement in renal function. One patient suffered an acute post-procedural deterioration in renal function. In total, 60% of the filter baskets contained embolic material. This study confirms the technical feasibility of renal artery stent deployment with adjuvant embolic protection. The excellent results for renal preservation at 6 months post-intervention also suggest that a distal embolic protection device may improve the impact of percutaneous renal revascularization on progressive deterioration in renal function. The postulated mechanism is through the prevention of atheromatous embolization and the embolic yield from the distal filters supports this hypothesis. Patients most likely to receive the greatest benefit are those with mild baseline chronic renal insufficiency and a recent decline in renal function.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Embolism
Renal function
Revascularization
Renal artery stenosis
urologic and male genital diseases
Kidney
Renal Artery Obstruction
Catheterization
Ischemia
medicine.artery
Internal medicine
Angioplasty
medicine
Humans
Embolization
Prospective Studies
Renal artery
Aged
renal artery stenosis
Aged, 80 and over
business.industry
Stent
Prostheses and Implants
Middle Aged
medicine.disease
Surgery
Treatment Outcome
Nephrology
Regional Blood Flow
Creatinine
Cardiology
ischemic nephropathy
Disease Progression
Ischemic Nephropathy
atheromatous embolization
Female
Stents
business
Angioplasty, Balloon
Filtration
Subjects
Details
- ISSN :
- 00852538
- Volume :
- 70
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Kidney international
- Accession number :
- edsair.doi.dedup.....1facdf8d4196d0410fe374de75ae5828