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.

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.

scholarly journals Non-invasive investigations of potential renal artery stenosis in renal insufficiency

2010 ◽  
Vol 25 (11) ◽  
pp. 3607-3614 ◽  
Author(s):  
P. Eriksson ◽  
A. A. Mohammed ◽  
J. De Geer ◽  
J. Kihlberg ◽  
A. Persson ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Non Invasive

Captopril-Induced Functional Renal Insufficiency in Patients with Bilateral Renal-Artery Stenoses or Renal-Artery Stenosis in a Solitary Kidney

1983 ◽  
Vol 308 (7) ◽  
pp. 373-376 ◽  
Author(s):  
Donald E. Hricik ◽  
Philip J. Browning ◽  
Richard Kopelman ◽  
Warren E. Goorno ◽  
Nicolaos E. Madias ◽  
...  
Keyword(s):  
Renal Insufficiency ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Solitary Kidney ◽  
Artery Stenosis ◽  
Bilateral Renal Artery ◽  
Renal Artery Stenoses

scholarly journals Spleno-renal anastomotic bypass revascularization for worsening renal failure and uncontrolled hypertension in bilateral calcific atherosclerotic renal artery stenosis

2019 ◽  
Vol 8 (4) ◽  
pp. 253-256
Author(s):  
Macaulay Amechi Chukwukadibia Onuigbo ◽  
Marie Engesser ◽  
Sree Susarla
Keyword(s):  
Renal Failure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Therapeutic Option ◽  
Artery Stenosis ◽  
Uncontrolled Hypertension ◽  
Recent Experience ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Revascularization Therapy ◽  
Atherosclerotic Renovascular Disease

Following the recent publications of the STAR-study, the ASTRAL trial, the HERCULES trial and the CORAL trial on renal revascularization versus medical therapy in the management of atherosclerotic renovascular disease, there has been a near paradigm shift implying the nonutility of revascularization as a useful and necessary therapeutic option. Our recent experience with a patient who underwent an anastomotic bypass revascularization for worsening renal failure and uncontrolled hypertension in bilateral calcific atherosclerotic renal artery stenosis in Burlington, VT rekindled this debate. We posit that in appropriately selected patients, patients with acutely worsening renal failure, uncontrolled hypertension and/or symptomatic pulmonary edema, there is indeed a place for revascularization therapy, especially in the light of improved and safer surgical and anesthesiology techniques. It must be correctly acknowledged that the above well popularized randomized trials recruited mostly patients with otherwise stable chronic kidney disease at the time of enrollment. Similarly, only 12% of the patients in both arms of the ASTRAL trial demonstrated rapidly worsening renal failure prior to enrollment

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