Follow-up of primary Palmaz-Schatz stent placement for atherosclerotic renal artery stenosis

Abstract

A Palmaz-Schatz ™ stent was successfully placed in 92 stenotic renal arteries (76 patients) for (1) hypertension in 62 (82%), and/or (2) chronic renal failure (serum creatinine ≥ 1.5 mg/dl) and preservation of renal function in 39 (51%). Patients were followed to assess clinical and angiographic 6-month outcome. Angiography, performed in 45 of 62 eligible patients (73%) and in 56 of 74 treated arteries (76%), showed restenosis occurring in 14 renal arteries (25%). Serum creatinine improved or remained stable in 78% of patients. In patients with chronic renal failure, improvement or stability was observed in 55%. Blood pressure recordings significantly decreased for the entire cohort (systolic: 168 ± 25 to 156 ± 22 mm Hg, p < 0.0001; diastolic: 87 ± 11 to 81 ± 11 mm Hg, p < 0.005), and for hypertensive patients with normal creatinine (systolic: 179 ± 20 to 155 ± 23 mm Hg, p < 0.0001; diastolic: 92 ± 9 to 83 ± 12 mm Hg, p < 0.002). These follow-up data of a prospective, nonrandomized, observational study showed that stent recanalization of atherosclerotic renal artery stenoses was beneficial with regard to renal function and blood pressure response, and had a restenosis incidence of 25%.