scholarly journals Renal Artery Stenting in Patients With Uncontrolled Hypertension: Should We? And to Whom?

2014 ◽  
Vol 16 (7) ◽  
pp. 479-481
Author(s):  
Baris Afsar ◽  
Adrian Covic ◽  
Mehmet Kanbay
Keyword(s):  
Renal Artery ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting

Significant reduction in systolic blood pressure following renal artery stenting in patients with uncontrolled hypertension: Results from the HERCULES trial

2012 ◽  
Vol 80 (3) ◽  
pp. 343-350 ◽  
Author(s):  
Michael R. Jaff ◽  
Mark Bates ◽  
Timothy Sullivan ◽  
Jeffrey Popma ◽  
Xingyu Gao ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Systolic Blood Pressure ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting

scholarly journals Long-term mortality after renal artery stenting in patients with severe atherosclerotic renal artery stenosis and high-risk clinical manifestations

2021 ◽  
Author(s):  
M I Dregoesc ◽  
S D Bolboacă ◽  
P M Doroltan ◽  
M Istrate ◽  
M C Marc ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Risk ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Clinical Manifestations ◽  
Artery Stenosis ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting ◽  
Long Term Mortality

Abstract Background Atherosclerotic renal artery stenosis is a risk factor for cardiovascular death. Observational studies support the benefit of renal revascularization on outcomes in selected patients with high-risk clinical manifestations. In this context, we evaluated the factors associated with long-term mortality after renal artery stenting in patients with severe renal artery stenosis, impaired kidney function and/or uncontrolled hypertension. Methods The medical records of patients undergoing renal artery stenting between 2004 and 2014 were extracted. Blood pressure and creatinine were recorded at baseline, 24 hours post-stenting and in the one month to one year interval that followed revascularization. Long-term follow-up was performed in March 2020. Results The cohort consisted of 65 patients. Median follow-up was 120 months. In the first year after stenting, less patients had chronic kidney disease (CKD) class 3b – 5 as compared to baseline (35.3 vs. 56.9%, p=0.01). The number of patients with controlled blood pressure after revascularization increased with 69.2% (p<0.001). Long-term all-cause mortality reached 44.6%. Age (OR 1.1; 95%CI 1.0–1.2; p=0.01), male gender (OR 7.9; 95%CI 1.9 – 43.5; p=0.008), post-stenting CKD class 3b-5 (OR 5.8; 95%CI 1.5–27.9; p=0.01), and post-revascularization uncontrolled hypertension (OR 8.9; 95%CI 1.7–63.5; p=0.01) were associated with long-term mortality independent of diabetes mellitus and coronary artery disease. Conclusion Improved CKD class and blood pressure were recorded in the first year after renal artery stenting in patients with severe renal artery stenosis and high-risk clinical manifestations. The lack of improvement in kidney function and blood pressure was independently associated with long-term mortality.

Intravascular Ultrasound—Guided Renal Artery Stenting

2001 ◽  
Vol 8 (3) ◽  
pp. 238-247 ◽  
Author(s):  
George Dangas ◽  
John R. Laird ◽  
Roxana Mehran ◽  
Alexandra J. Lansky ◽  
Gary S. Mintz ◽  
...  
Keyword(s):  
Renal Artery ◽  
Intravascular Ultrasound ◽  
Uncontrolled Hypertension ◽  
Lesion Length ◽  
Antihypertensive Medications ◽  
Luminal Diameter ◽  
Arterial Blood ◽  
Renal Artery Stenting ◽  
Blood Pressures ◽  
The Mean

Purpose: To evaluate the clinical outcomes of patients undergoing renal artery stenting with intravascular ultrasound (IVUS) guidance and compare measurements between IVUS and angiography. Methods: One hundred thirty-one patients (71 women; mean age 71 ± 8 years) underwent IVUS-guided Palmaz stent implantation in 153 stenotic renal arteries at a single center. The indications for stenting were uncontrolled hypertension (102, 77.9%), renal insufficiency (10, 7.6%), and both conditions (19, 14.5%). The majority of lesions were ostial (114, 74.5%); the remainder occupied the proximal renal artery (39, 25.5%). The mean lesion length and diameter stenosis were 6.5 ± 3.0 mm and 74% ± 10%, respectively, as measured by angiography. Data were recorded in a pre-specified database; angiographic and IVUS images were analyzed at dedicated core laboratories and compared. Results: Angiographic success was achieved in all patients, but IVUS indicated the need for additional intervention in 36 (23.5%) cases. There was strong correlation between the angiographic and IVUS measurements of lesion length ( r = 0.60, p < 0.0001) and pre-/postprocedural minimal luminal diameter ( r = 0.72 and 0.63, respectively; p < 0.0001). The mean contrast volume was 74 ± 18 mL per case. In-hospital renal failure occurred in 8 (6.1%) patients; 2 (1.5%) required transient hemodialysis. At a mean 15-month follow-up, patients were treated with fewer antihypertensive medications (p = 0.05), and systolic and diastolic arterial blood pressures had decreased (p = 0.001); no significant change was noted in serum creatinine. Conclusions: IVUS-guided stenting facilitates safe renal artery revascularization. IVUS imaging may complement angiography in certain cases, which should be studied further in prospective studies with iodinated or noniodinated contrast agents.

Stenting of the Renal Artery to Improve Renal Function Prior to Thoracoabdominal Aneurysm Repair

1998 ◽  
Vol 5 (1) ◽  
pp. 56-59 ◽  
Author(s):  
Timothy M. Sullivan ◽  
Norman R. Hertzer
Keyword(s):  
Renal Insufficiency ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Artery Stenosis ◽  
Uncontrolled Hypertension ◽  
Secondary Patency ◽  
Type Iv ◽  
Renal Artery Stenting ◽  
Staged Treatment

Purpose: To report the successful staged treatment of a patient with a thoracoabdominal aortic aneurysm (TAA), who presented with renal insufficiency attributable to renal artery stenosis. Methods and Results: A 66-year-old woman with a 6-cm Crawford type IV TAA presented with uncontrolled hypertension (240/130 mmHg), worsening congestive heart failure, and progressive renal insufficiency (serum creatinine 3.8 mg/dL) caused by renal artery stenosis to a solitary functioning kidney. Renal artery stenting restored normal renal and pulmonary function, and elective TAA repair 6 weeks after percutaneous stenting was uneventful. Restenosis (50% diameter reduction) in the renal artery was found 10 months later and treated with repeat dilation. Secondary patency was maintained at follow-up 21 months after redilation. Conclusions: It appears feasible to use preliminary renal artery stenting to reduce operative risk in TAA surgical candidates with renal insufficiency secondary to renal artery stenosis.

P3570Bilateral renal artery stenting is effective method for the treatment of uncontrolled hypertension and renal function

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Uzokov ◽  
A L Alyavi ◽  
B A Alyavi ◽  
S A Iskhakov ◽  
D D Payziev
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Serum Creatinine ◽  
Renal Artery ◽  
Uncontrolled Hypertension ◽  
Renal Artery Stenting ◽  
Group I ◽  
Group Ii ◽  
Bilateral Stenting

Abstract Background Renal artery (RA) stenosis is one of the main causes of severe uncontrolled primary hypertension among population. Aim of the study was to investigate effectiveness of stent replacement in renal arteries and influence it on renal function in uncontrolled hypertensive patients (UHP) with pharmacotherapies. Methods 86 consecutive UHP with renal etiology confirmed by angiography were enrolled in this study. Mean age of the patients was 43.2±12.5 years (aged 31–59 years, male=46%). Blood pressure, serum creatinine, microalbuminuria were assessed at baseline and after the intervention and during the follow-up for statistics. Mean follow-up was 2.0±1.0 years. Results Total of 128 hemodynamically significant renal artery stenosis were treated by implanting stents in all 86 patients. Among them in 42 patients were performed bilateral stenting (Group I) and 44 patients unilateral stenting (Group II). Systolic and diastolic blood pressure (SBP, DBP) decreased in both groups during the follow-up, however it was noted that only SBP were decreased significantly in Group I (unilateral stenting) whilst reduction in DBP not significantly when compared to Group II. Mean reduction in SBP was from 165.0±20.5 mmHg to 130.4±14.0 mmHg in Group I vs. from 158.0±22.0 to 135.0±15.0 mmHg in Group II (P=0.003 when compared two groups) and in DBP was from 95.0±11.2 mmHg to 83.4±8.0 mmHg in Group I vs. from 93.0±10.0 to 82.0±7.5 mmHg in Group II (P>0.05 when compared two groups). Serum creatinine levels were reduced from 123.0±49.0 μmol/l to 85.4±30.6 μmol/l in Group I vs 116.8±51.2 μmol/l to 86.9±35.5 μmol/l (P<0.05 when compared two groups). Significantly reduction in MAU were noted in both groups (P<0.05) but when compared two groups there were no significant changes in reduction. Conclusion Renal artery stenting is effective method for the treatment of UHP and may improve outcomes of the patients. Bilateral stenting seems to be more effective in blood pressure and serum creatinine control in UHP.

Embolic Protection and Antiplatelet Use for Renal Artery Stenting

2008 ◽  
Vol 3 (1) ◽  
pp. 79
Author(s):  
William R Colyer ◽  
Christopher J Cooper ◽  
◽  
Keyword(s):  
Renal Artery ◽  
Embolic Protection ◽  
Renal Artery Stenting

Bilateral Renal Artery Stenting in a Patient with Leriche Syndrome

2004 ◽  
Vol 73 (3) ◽  
pp. 283-284 ◽  
Author(s):  
Mourikis Dimitrios ◽  
Chatziioannou Achilles ◽  
Koureas Andrew ◽  
Ladopoulos Charalampos ◽  
K. Katsenis ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenting ◽  
Leriche Syndrome ◽  
Bilateral Renal Artery
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