To determine primary rates in small-diameter renal arteries, including complex bifurcation lesions, treated with drug-eluting stents (DES) in patients with atherosclerotic renal artery stenosis.
Materials and Methods
This is a retrospective single-institution study. A total of 37 patients with 39 stented renal arteries were included. Patient and procedural data were obtained from the electronic medical record. Survival free from restenosis was estimated using the Kaplan–Meier method with patients stratified into two groups based on renal artery diameters (≤ 3.5 mm or > 3.5 mm). Univariate Cox proportional models were used to estimate hazard ratios associated with clinical and angiographic variables.
Average renal artery diameter at time of treatment was 3.4 mm ± 0.4 mm. The median survival free from restenosis was 992 days, with 11 out of 37 (29.7%) developing an in-stent restenosis. Renal arteries < 3.5 mm in diameter had similar patency rates as renal arteries > 3.5 mm (P = 0.33). The 1-, 2-, and 5-year patency rates were 71%, 63%, and 38%, respectively. History of stroke was the only comorbidity to portend a significantly greater rate of restenosis (hazard ratio 3.77; 95%CI, 1.05–13.6; P = 0.04). Medications did not statistically alter the risk of restenosis.
Revascularization of renal arteries with DES achieved similar primary patency rates irrespective of renal artery diameter. Stent configuration was not associated with time to renal replacement therapy or all-cause mortality.
Level of Evidence
Level 3, Cohort Study.
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SM has funding from National Institutes of Health Grant DK107870 from the National Heart, Lung, and Blood Institute (HL 098967)
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The authors declare that they have no conflict of interest.
This study has obtained IRB approval from the Mayo Clinic IRB committee, and the need for informed consent was waived.
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Jundt, M.C., Takahashi, E.A., Harmsen, W.S. et al. Restenosis Rates After Drug-Eluting Stent Treatment for Stenotic Small-Diameter Renal Arteries. Cardiovasc Intervent Radiol 42, 1293–1301 (2019). https://doi.org/10.1007/s00270-019-02264-z
- Drug-eluting stent
- Renal artery stenosis
- Renal replacement therapy