Long-term clinical outcome of patients with severe atherosclerotic renal artery stenosis after percutaneous transluminal renal angioplasty

Abstract

BackgroundIn the patients with severe atherosclerotic renal artery stenosis (ARAS), the evaluation of long-term clinical outcome after percutaneous transluminal renal angioplasty (PTRA) has yet been insufficient. The aim of this study was to focus on only patients with severe ARAS and to evaluate the more long-term clinical outcome after PTRA.MethodsWe performed a single-center retrospective review of the outcome after PTRA. All eligible patients had ARAS of ≥ 75% by catheter renal angiography and underwent PTRA in our hospital from July 2004 to December 2007. We investigated long-term changes of renal function and the other clinical outcomes in patients with severe ARAS.ResultsThe median follow-up period was 83 months. The overall mean stenosis rate was 87%. There were 24 patients with 75 ≤ and < 90%, 38 patients with 90 ≤ and < 95%, and 12 patients with ≥ 95% stenosis. Serum creatinine(S-Cr) levels were from 1.27 ± 0.68 at baseline to 1.33 ± 0.65 mg/dl at 84 months after PTRA in overall (p = 0.255). The renal size was also preserved for long-term in overall. Although serum creatinine level in patients with renal major axis < 85 mm at PTRA significantly increased (p < 0.05) after 60 months post PTRA, it did not worsen in patients with renal major axis more than 85 mm during observational period. The number of anti-hypertension drugs decreased from baseline (p = 0.0037), and both systolic and diastolic blood pressure significantly decreased (p < 0.001) after PTRA. Finally, 4 patients had renal death, and 14 patients died. Overall survival for 60 months was 85%.ConclusionsWe demonstrated that PTRA for patients with severe ARAS significantly decreased blood pressure, and preserved renal function and renal size for long term.Trial registrationThis study was admitted by Tokushukai Group Institutional Review Board.(IRB no. TGE00532-024)