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ORIGINAL ARTICLE
Year : 2013  |  Volume : 25  |  Issue : 2  |  Page : 98-103

Renal artery stenting ( early results)


1 Department of Surgery, Cairo University, Cairo, Egypt
2 Department of Internal Medicine, Cairo University, Cairo, Egypt
3 Department of Radiology, Cairo University, Cairo, Egypt

Correspondence Address:
Hesham N. Abdel Mooty
MD, Department of Surgery, Faculty of Medicine, Cairo University, 11211 Giza
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.7123/01.EJIM.0000427959.28219.4d

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Background

Atherosclerotic renovascular disease (ARVD) is defined as renal artery stenosis with an occlusion of 60% or more. It is an established cause of resistant hypertension and renal insufficiency. ARVD is evaluated using renal artery duplex ultrasound, which measures the degree of renal artery stenosis and renal resistance index. Treatment with renal artery balloon angioplasty and stents has been shown to improve blood pressure and renal function in some patients.

Aim of the study

This was a prospective study evaluating the early effects of renal artery angioplasty and stenting in patients with ARVD as regards the blood pressure and renal function.

Methods

During March 2009 to September 2011, 37 patients (21 men and 16 women) with ARVD (unilateral or bilateral), resistant hypertension, and renal impairment were selected and divided into two groups: group A (25 patients) comprised patients who underwent renal artery balloon angioplasty and stenting (intervention group) and group B (12 patients) comprised those who were kept on medical treatment as controls and followed up without intervention.

Results

Two weeks after intervention, eight patients (32%) stopped one medication, seven patients (28%) stopped two medications (i.e. one antihypertensive medication only), and five patients (20%) stopped all medications, whereas the blood pressure did not change in five patients (20%). The average mean systolic blood pressure of group A was 140 mmHg and the average serum creatinine level was 2.1. As regards group B, the average mean systolic blood pressure was 170 mmHg for patients who were on three antihypertensive medications, and the average serum creatinine level was 2.4.

Conclusion

The main effect of renal artery revascularization in ARVD is on blood pressure control in patients with resistant hypertension, with minimal influence on the renal function.



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