SHOULD PERCUTANEOUS TRANSLUMINAL RENAL-ARTERY ANGIOPLASTY BE APPLIED TO OSTIAL RENAL-ARTERY ATHEROSCLEROSIS

Purpose: The purpose of this study was to review the results of percut aneous transluminal renal artery angioplasty (PTRA) in patients with a therosclerosis to assess safety, anatomic and functional outcome, and differences in outcome between ostial and nonostial lesions. Methods: We used retrospective review of 52 consecutive patients who had underg one attempted PTRA for renal artery atherosclerosis during the calenda r years 1987 to 1992. Results: Fifty-two patients had 60 renal arterie s on whom PTRA. was attempted. The mean age was 68 years. Atherosclero sis was generalized in 81% of the patients. The indication for angiopl asty was salvage of functioning renal parenchyma in 81% of patients. E ight patients were undergoing dialysis at the time of attempted PTRA. Five arteries (8%) could not be dilated. There were one cardiac death and two arterial complications requiring surgery within 30 days. Thirt y-five percent of patients with available angiograms had an anatomic i mprovement above a threshold of one stenotic group (30% to 40% diamete r improvement), with residual stenosis of less than 50%. Half of patie nts treated for hypertension had improvement in their hypertension. Ov erall, there was no change in creatinine levels before and after the p rocedure. Four of eight patients undergoing dialysis at the time of PT RA were able to discontinue dialysis during follow-up. four patients ( 11%) required surgical bypass and five patients (14%) required chronic dialysis during follow-up. Conclusions: Modest success at low risk ca n be expected from PTRA in a group of patients with severe atheroscler osis. No significant difference in results between ostial and nonostia l lesions was noted.