The feasibility, safety, and mid-term outcomes of concomitant percutaneous transluminal renal artery stenting in acute coronary syndrome patients at high clinical risk of renal artery stenosis

Concomitant renal artery stenosis (RAS) aggravates the presentations and outcomes of coronary artery disease. To date, no reports have been published on the feasibility, safety, and outcomes of concomitant percutaneous renal artery stenting (PTRS) in patients presenting with acute coronary syndrome (ACS) at high clinical risk of RAS.This was a retrospective study. Eighty-two patients who were at high clinical risk of RAS, undergoing simultaneous coronary and renal angiographies between January 2005 and July 2011, were queried from the data of 2186 ACS patients.A total of 80 patients (48 males; age, 77 ± 8 years) were enrolled. Thirty-five patients (43.8%) were found to have significant RAS and all received PTRS. Peripheral arterial disease (PAD) was found to be the only predictive factor for RAS in multivariate analysis. There were no significant differences in the total procedural/fluoroscopic times or the volume of contrast used between RAS/PTRS and non-RAS groups. No extra procedure-related morbidities occurred in the RAS/PTRS group. There were no significant differences in serum creatinine, estimated glomerular filtration rate, or clinical outcomes between the groups at different follow-up points. However, the mean number of antihypertensives decreased significantly 3 months after PTRS. The systolic and diastolic blood pressures also significantly lowered 6 months after PTRS.Significant RAS was not infrequently found in ACS patients at high clinical risk. PAD was the only independent predictive factor. Concomitant PTRS could be safely and effectively performed in the same session as coronary interventions with favorable outcomes.