Renal Artery Stent Placement for the Management of Ischemic Nephropathy

摘要: Purpose To evaluate the angiographic and clinical results of percutaneously implanted renal artery endoprostheses (stents) for treatment patients with ischemic nephropathy. Materials Methods During a 52-month period, 45 azotemia (serum creatinine ≥ 1.5 mg/dL) atheromatous stenosis untreatable by, or recurrent after, balloon angioplasty were treated by percutaneous placement Palmaz stents. Stent implantation was unilateral in 32 cases bilateral 11 cases. Clinical determined measurements serum follow-up angiography. benefit defined as stabilization improvement level. Angiographic patency less than 50% diameter arterial stenosis. Results technically successful 51 54 (94%) arteries. Technical failures stent misdeployment requiring retrieval ( n = 2) inadvertent distal to desired position 1). Complications included acute thrombosis 1) early initiation hemodialysis (within 30 days; There two periprocedural deaths. With use life-table analysis, seen 78% at 6 months 36), 72% 1 year 24), 62% 2 years 12), 54% 3 3). In benefit, average level reduced from 2.21 mg/dL ± 0.91 before 2.05 1.05 after P .018). Lower initial associated better chance .05). No other variables affected outcome, including patient age, sex, diabetes, diameter, versus placement, ostial nonostial positioning. Conventional catheter angiography spiral computed tomographic (CT) performed 19 (28 stents) mean interval 12.5 demonstrated primary 75%. Maintained appeared correlate functional benefit. Conclusions Percutaneous restenoses provides most