TREATMENT OF RENAL ANGIOPLASTY FAILURE BY PERCUTANEOUS RENAL-ARTERY STENTING WITH PALMAZ STENTS - MIDTERM TECHNICAL AND CLINICAL-RESULTS

OBJECTIVE. Renal artery stenting has recently been used to treat failu res or complications of renal angioplasty. Although technical results and complication rates have been reported, clinical follow-up and long -term data are limited. The purpose of this study was to evaluate the midterm clinical efficacy and safety of Palmaz stents in rescuing rena l artery angioplasty failures. MATERIALS AND METHODS. Palmaz stents we re placed in 35 renal arteries of 33 patients (14 men and 19 women; 37 -77 years old; mean age, 62.6 years old) for immediate angioplasty fai lure (29 arteries) or for recurrent stenosis after previous angioplast y (six arteries). Indications for treatment were hypertension alone (1 6 patients) or hypertension associated with renal failure (17 patients ). Blood pressure, medication, and serum creatinine level were followe d after stenting. RESULTS. No residual stenosis was found immediately after stenting. Mean clinical follow-up was 13.4 months (range, 1-34 m onths). Of the 33 patients, two (6%) were cured of their hypertension, 20 (61%) were improved, and 11 (33%) did not respond to renal artery stenting. Of the 17 patients whose serum creatinine level was greater than 132 mu mol/dl (1.5 mg/dl), seven (41%) were improved by renal art ery stenting, six (35%) were stabilized, and renal function deteriorat ed in four (24%). Of the 33 patients, seven developed complications in cluding one renal artery thrombosis, four renal artery emboli, one cho lesterol embolization to the lower limbs, and one femoral hematoma tha t required surgery. CONCLUSION. Midterm results of renal artery stenti ng with the Palmaz stent to treat immediate or late angioplasty failur es reveal improvements in blood pressure and renal function similar to those of successful primary balloon angioplasty.