Outcomes and efficacy of percutaneous transluminal renal artery angioplasty with stent in patients with atherosclerotic renal artery stenosis

Abstract

Objectives: Renal artery stenosis is the most common cause of secondary hypertension. The aim of this study is to evaluate the outcomes of percutaneous transluminal renal artery angioplasty and stenting (PTRAS) procedure for atherosclerotic renal artery stenosis (ARAS) which is the most common cause of secondary hypertension. Materials and Methods: This retrospective chart review included 27 patients who had PTRAS procedure from 2012 to 2017. This procedure was performed to patients with ARAS whose luminal narrowing was ≥70%. Successful intervention was accepted when the residual stenosis was <20%. Results: The mean age of 27 patients with ARAS was 71.4±11.1 years, and 55.6% were male. Most common indication for renal angiography was uncontrolled hypertension (85.2%). PTRAS was indicated due to hypertension resistant to medical treatment in 92.6% of the patients. About 96.3% of the cases had hypertension. Renal artery stenosis was present on the right in 23 patients (85.2%) and on the left in 20 patients (74.1%). Bilateral renal artery stenosis was diagnosed in 16 patients (59.3%). Predilatation was performed in nine cases (33.3%) with right stenosis and in 10 cases (37%) with left stenosis, and direct stenting was applied in seven (25.9%) and six (22.2%) of cases, respectively. The overall mortality rate was 22.2% during 5-year follow ups. No other major events were noted. Conclusion: PTRAS is associated with improved blood pressure control, renal functions, and survival, and it can be performed with high success and low complication rates. Nevertheless, each patient should be evaluated individually for the risks and benefits.