Stent placement in ostial and nonostial atherosclerotic renal arterial stenoses: A prospective follow-up study

PURPOSE: To compare the results of balloon percutaneous transluminal renal angioplasty (PTRA) and stent placement in atherosclerotic ostial, proximal, and isolated truncal stenoses. MATERIALS AND METHODS: Between January 1994 and April 1998 the authors pros pectively followed up 163 consecutive patients with 200 atherosclerotic ren al arterial lesions after primary PTRA or primary stent placement. Duplex u ltrasonography was performed 1 day and 3, 6, and 12 months later. RESULTS: The primary 12-month PTRA patency rates were 34% (21 of 33 atheros clerotic lesions) for ostial stenoses, 65% (20 of 60) for proximal stenoses , and 83% (five of 30) for truncal stenoses (chi(2) value, 15.63; P < .001) . The corresponding stent patency rates were 80% (four of 21), 72% (nine of 34), and 66% (five of nine), respectively (chi(2) value, 4.11; not signifi cant). Significant stent-related reduction in risk of restenosis was limite d to the ostial stenoses (P = .002). CONCLUSION: Renal arterial stent placement considerably improves patency in ostial stenoses, but compared with the technically successful PTRA, it doe s not significantly improve primary patency in proximal and isolated trunca l renal arterial stenoses.