Stent placement for renal arterial stenosis: Where do we stand? A meta-analysis

PURPOSE: To perform a meta-analysis of renal arterial stent placement in co mparison with renal percutaneous transluminal angioplasty (PTA) in patients with renal arterial stenosis. MATERIALS AND METHODS: Studies dealing with renal arterial stent placement (14 articles; 678 patients) and renal PTA (10 articles; 644 patients) publi shed up to August 1998 were selected. A random-effects model was used to po ol the data. RESULTS: Renal arterial stent placement proved highly successful, with an i nitial adequate performance in 98% and major complications in 11%. The over all cure rate for hypertension was 20%, whereas hypertension was improved i n 49%. Renal function improved in 30% and stabilized in 38% of patients. Th e restenosis rate at follow-up of 6-29 months was 17%. Stent placement had a higher technical success rate and a lower restenosis rate than did renal PTA (98% vs 77% and 17% vs 26%, respectively; P < .001). The complication r ate was not different between the two treatments. The cure rate for hyperte nsion was higher and the improvement rate for renal function was lower afte r stent placement than after renal PTA (20% vs 10% and 30% vs 38%, respecti vely; P < .001). CONCLUSION: Renal arterial stent placement is technically superior and clin ically comparable to renal PTA alone.