Successful endovascular treatment of chronic renal artery occlusion: a preliminary retrospective case series including 15 patients

Int Urol Nephrol. 2019 Feb;51(2):285-291. doi: 10.1007/s11255-018-02067-0. Epub 2019 Jan 3.

Abstract

Purpose: To evaluate in a retrospective, single-center, case series if percutaneous transluminal renal angioplasty/stenting of chronic renal artery occlusion is beneficial to renal function and blood pressure control, which remains controversial.

Methods: Data from 15 consecutive patients with renal artery stump who underwent successful percutaneous transluminal renal angioplasty/stenting only for unilateral chronic renal artery occlusion at our center from January 2007 to February 2018 and completed follow-up were retrospectively evaluated. Of the 15 patients, 14 (93.3%) were treated with stenting and 1 with only balloon angioplasty. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula corrected for Chinese, and changes in blood pressure and need for antihypertensive medications were recorded.

Results: At median 1.5-year (interquartile range 0.5-5.0) follow-up, restenosis rate was 20.0%. Renal function improved or remained stable in 26.7% and 53.3% of patients, respectively, and blood pressure normalized or improved in 13.3% and 40.0% of patients, respectively. Young patients with Takayasu's arteritis or fibromuscular dysplasia appeared to benefit the most from revascularization.

Conclusions: In this preliminary retrospective series of select patients with renal artery stump, endovascular treatment of chronic renal artery occlusion appeared to preserve renal function and improve blood pressure.

Keywords: Blood pressure; Percutaneous transluminal renal angioplasty; Renal artery occlusion; Renal artery stenting; Renal function.

MeSH terms

  • Aged
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation
  • Angioplasty, Balloon / methods
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure Determination
  • China / epidemiology
  • Endovascular Procedures / adverse effects
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods
  • Female
  • Glomerular Filtration Rate
  • Graft Occlusion, Vascular / epidemiology*
  • Humans
  • Hypertension, Renovascular* / diagnosis
  • Hypertension, Renovascular* / etiology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Renal Artery Obstruction* / complications
  • Renal Artery Obstruction* / diagnosis
  • Renal Artery Obstruction* / physiopathology
  • Renal Artery Obstruction* / surgery
  • Renal Artery* / diagnostic imaging
  • Renal Artery* / physiopathology
  • Stents*

Substances

  • Antihypertensive Agents