Atherosclerotic Renal Arterial Stenosis: Clinical Outcomes of Stent Placement for Hypertension and Renal Failure

Abstract

The authors performed primary stent placement in 100 patients with atherosclerotic renal arterial stenosis to determine the technical success rate and long-term clinical outcome. Twenty-five patients had resistant hypertension, 50 had impaired renal function and 25 had both. Angiography was used to evaluate immediate technical results. Serial systolic and diastolic blood pressure and serum creatinine values were reviewed to assess clinical outcomes. Follow up continued every 6 months after the procedure and results were compared with those obtained at the time of the procedure. The result was a 95.2% technical success rate. Of 48 patents, resistant hypertension was improved in 38, cured in two, but failed to respond in 8 patients. Mean blood pressures (systolic and diastolic) were significantly lower through follow-up at 30 months than before the procedure. In the 65 patients treated for renal impairment, function stabilized in 25, improved in 20, and continued to deteriorate in 20. Complications occurred in 18 cases, of which 8 were major and included 2 procedure-related deaths. The authors concluded that primary stent placement for resistant hypertension and recovery of renal function has a high technical success rate and produces clinical benefits in most patients.