RESULTS OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR ATHEROSCLEROTIC RENAL-ARTERY STENOSIS - A FOLLOW-UP-STUDY WITH DUPLEX ULTRASONOGRAPHY

Purpose: The short and long-term anatomic results of percutaneous tran sluminal renal angioplasty (PTRA) in the treatment of atherosclerotic renovascular disease have been poorly documented because of a lack of follow-up arteriography. The purpose of this study was to evaluate the anatomic results of PTRA with serial duplex examinations. Methods: Th e records of 41 patients who underwent 52 primary PTRA procedures and had subsequent duplex follow-up of at least 6 months were reviewed. Af ter PTRA, renal arteries were classified as normal, <60% stenosis, gre ater than or equal to 60% stenosis, or occluded on the basis of previo usly validated duplex criteria. Results: The study group included 26 m en and 15 women with a mean age of 65 years, who were observed for a m ean interval of 34 months. Endovascular stents were placed in 12 of th e 52 arteries. The initial post-PTRA. renal artery stenosis classifica tion (based on arteriography or duplex scan) was normal in 23, <60% in 19, and greater than or equal to 60% in 10. The cumulative incidence of restenosis from normal to greater than or equal to 60% was 13% at 1 year and 19% at 2 years. The cumulative incidence of restenosis from <60% to greater than or equal to 60% to was 44% at 1 year and 55% at 2 years. The cumulative incidence of progression from greater than or e qual to 60% to occlusion was 10% at 2 years. Although 83% of the 12 st ented arteries and only 33% of the 40 nonstented arteries were normal immediately after PTRA, after 1 year the stented renal arteries showed a 44% restenosis rate, whereas the nonstented renal arteries showed a 18% restenosis rate (p=0.087). Conclusions: Restenosis after PTRA. fo r atherosclerotic disease is relatively common and correlates with the initial anatomic result Although PTRA with stent placement yields sup erior immediate technical results, the high early restenosis rate is d isturbing.