Abstract

HAMDAN, Nabil et al. Angioplasty and stent implantation in patients with renal artery stenosis. Rev. Col. Cardiol. [online]. 2005, vol.12, n.1, pp.37-44. ISSN 0120-5633.

Introduction and objectives: renal artery atherosclerotic disease is considered a common cause of systemic arterial hypertension and renal insufficiency. Percutaneous treatment is a safe procedure, with low morbidity and mortality and a high success rate. It allows to control or to cure systemic arterial hypertension and to stabilize renal function (10). The efficacy of angioplasty with stent implantation in patients with significant renal artery stenosis will be evaluated in this study. Material and methods: this study is a historic cohort in which 28 patients with significant renal artery stenosis underwent angioplasty and stent implantation in a period between January 1, 2001 and December 21, 2003. An intra-hospital 12 months follow-up was performed and the arterial hypertension and the renal function were primarily evaluated. Results: after the percutaneous intervention in the hospitalized patient, the arterial blood pressure could be reduced in a significant way, both systolic from 171.5 mm Hg to 144.5 mm Hg and diastolic from 94.9 mm Hg to 80.2 mm Hg. The control of the arterial blood pressure was achieved in 7 patients (25%). The renal function, according to the creatinine serum concentration remained stable with a discrete increment from 1.7 mg/dL to1.9 mgs/dL. In the 12 months follow-up the arterial systolic pressure was maintained in 142.6 mm Hg and the diastolic in 81.4 mm Hg. In 11 patients (39.3%) the arterial blood pressure remained under control. There was an improvement in the renal function in 5 patients (17.9%) and renal deterioration in 5 patients (17.9%), 4 of which required hemodialysis. The main creatinine serum concentration was 2.01 mg/dL with an increment of 0.31 mg/dL in regard to the basal concentration prior to the intervention. Conclusion: treatment with angioplasty and stent implantation must be considered as the first choice for patients with renal artery stenosis. This study shows a significant improvement in the systemic arterial hypertension management in a 12 months period, as well as a stabilization of the renal function.

Keywords : renal artery stenosis; angioplasty with balloon; stent; systemic arterial hypertension.

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