IMPROVED HEMODYNAMIC, ANGIOGRAPHIC AND FUNCTIONAL RESULTS AFTER RENAL-ARTERY STENTING

Eighteen patients with severe renal artery atherosclerosis underwent c onventional percutaneous transluminal renal angioplasty (PTRA) followe d immediately by implantation of an endovascular stent. Hemodynamic me asurements showed a baseline trans-stenotic pressure gradient of 78.3 mmHg that was reduced to 14.8 mmHg after PTRA. The post PTRA trans-ste notic pressure gradient was further reduced to 0.86 mmHg after stent p lacement. The average baseline diameter stenosis of 81.3% was reduced to 43.7% after PTRA and 6.1% after stent placement. Six month angiogra phic follow-up revealed restenosis in 6/16 patients. In patients treat ed for chronic renal insufficiency without restenosis the 6 month crea tinine was 1.46 mg/dl compared to a pre-procedure creatinine of 2.4 mg /dl. Therefore those patients with renal insufficiency and renal arter y stenosis who had long term patency after successful stent implantati on showed significant improvement in renal function at six months. Ste nt implantation also significantly improved acute hemodynamic results and acute angiographic results compared to conventional renal artery a ngioplasty.