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Clinical characteristics and treatment of renal artery fibromuscular dysplasia with percutaneous transluminal angioplasty: a long-term follow-up study

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Abstract

Background

Renal artery fibromuscular dysplasia (RAFMD) is a non-atherosclerotic cause of renal artery stenosis often affecting the young. Percutaneous transluminal renal angioplasty (PTRA) is the treatment of choice but there are few studies of the outcome of the procedure.

Methods

This retrospective analysis included 64 patients (56.2 % female; mean age at diagnosis, 28.0 years) with RAFMD who underwent PTRA between November 2003 and August 2015. Technical and clinical success rates and restenosis rates were evaluated.

Results

Seventy-six procedures were performed on 64 RAFMD patients. Technical success was 96.9 %, as defined by <30 % residual stenosis, with stent placement required in 11 patients (17.2 %). In the short term (1 month), the majority (79.7 %) had an immediate clinical benefit, with cure of hypertension in 35.9 %, and improvement in hypertension and a lower requirement for antihypertensive medications in 43.8 %. In the long term (mean, 47.5 months; range, 5–141 months), the survival rate was 96.9 %, freedom from restenosis was 84.4 %, and 76.6 % of patients showed a sustained clinical benefit (cure rate 40.6 %, improvement rate 35.9 %). Eight patients were treated with a second procedure and two had a third procedure, with half of these patients showing an improvement in hypertension.

Conclusion

PTRA for symptomatic RAFMD is safe and clinically successful. More than half of patients experience an immediate clinical benefit with sustained long-term effects. For patients with restenosis, there was a good response to a second PTRA.

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Acknowledgments

This work was supported by grants from the PUMC Graduate Innovation Fund (2015-1002-01-14) and the National Science Foundation of China (No. 81541010).

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Authors and Affiliations

  1. Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Beijing, 100037, China

    Y. K. Yang, Y. Zhang, X. Meng, K. Q. Yang, X. J. Jiang, H. Y. Wu, H. M. Zhang, L. Song, L. P. Wang & X. L. Zhou

  2. Department of Geriatric Cardiology, General Hospital of Chinese People’s Liberation Army, Beijing, 100853, China

    L. G. Gao

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  1. Y. K. Yang
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Correspondence to L. G. Gao or X. L. Zhou.

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Yang, Y.K., Zhang, Y., Meng, X. et al. Clinical characteristics and treatment of renal artery fibromuscular dysplasia with percutaneous transluminal angioplasty: a long-term follow-up study. Clin Res Cardiol 105, 930–937 (2016). https://doi.org/10.1007/s00392-016-1001-1

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  • DOI: https://doi.org/10.1007/s00392-016-1001-1

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