Abstract
Purpose
To evaluate in a retrospective, single-center, case series if percutaneous transluminal renal angioplasty/stenting of chronic renal artery occlusion is beneficial to renal function and blood pressure control, which remains controversial.
Methods
Data from 15 consecutive patients with renal artery stump who underwent successful percutaneous transluminal renal angioplasty/stenting only for unilateral chronic renal artery occlusion at our center from January 2007 to February 2018 and completed follow-up were retrospectively evaluated. Of the 15 patients, 14 (93.3%) were treated with stenting and 1 with only balloon angioplasty. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula corrected for Chinese, and changes in blood pressure and need for antihypertensive medications were recorded.
Results
At median 1.5-year (interquartile range 0.5–5.0) follow-up, restenosis rate was 20.0%. Renal function improved or remained stable in 26.7% and 53.3% of patients, respectively, and blood pressure normalized or improved in 13.3% and 40.0% of patients, respectively. Young patients with Takayasu’s arteritis or fibromuscular dysplasia appeared to benefit the most from revascularization.
Conclusions
In this preliminary retrospective series of select patients with renal artery stump, endovascular treatment of chronic renal artery occlusion appeared to preserve renal function and improve blood pressure.
Similar content being viewed by others
References
Textor SC (2017) Renal arterial disease and hypertension. Med Clin N Am 101:65–79
Van der Niepen P, Rossignol P, Lengelé J, Berra E, Sarafidis P, Persu A (2017) Renal artery stenosis in patients with resistant hypertension: stent it or not? Curr Hypertens Rep 19:5
Wright MP, Persad RA, Cranston DW (2001) Renal artery occlusion. BJU Int 87:9–12
Ma YC, Zuo L, Chen JH, Luo Q, Yu XQ, Li Y, Xu JS, Huang SM, Wang LN, Huang W et al (2006) Modified glomerular filtration rate estimating equation for Chinese patients with chronic kidney disease. J Am Soc Nephrol 17:2937–2944
Rundback JH, Sacks D, Kent KC, Cooper C, Jones D, Murphy T, Rosenfield K, White C, Bettmann M, Cortell S et al (2002) Guidelines for the reporting of renal artery revascularization in clinical trials. American Heart Association. Circulation 106:1572–1585
Jiang X, Peng M, Li B, Dong H, Che W, Zou Y, Yang Y, Gao R (2016) The efficacy of renal artery stent combined with optimal medical therapy in patients with severe atherosclerotic renal artery stenosis. Curr Med Res Opin 32:3–7
Oskin TC, Hansen KJ, Deitch JS, Craven TE, Dean RH (1999) Chronic renal artery occlusion: nephrectomy versus revascularization. J Vasc Surg 29:140–149
Alhadad A, Mattiasson I, Ivancev K, Gottsater A, Lindblad B (2004) Sustained beneficial effects on blood pressure during long time retrospective follow-up after endovascular treatment of renal artery occlusion. J Hum Hypertens 18:739–744
Cheung CM, Wright JR, Shurrab AE, Mamtora H, Foley RN, O’Donoghue DJ, Waldek S, Kalra PA (2002) Epidemiology of renal dysfunction and patient outcome in atherosclerotic renal artery occlusion. J Am Soc Nephrol 13:149–157
Whitehouse WJ, Kazmers A, Zelenock GB, Erlandson EE, Cronenwett JL, Lindenauer SM, Stanley JC (1981) Chronic total renal artery occlusion: effects of treatment on secondary hypertension and renal function. Surgery 89:753–763
Dostal G, Heihoff JJ, Jakubowski HD, Eigler FW (1983) Renal revascularisation in 36 patients with chronic total occlusion of the renal artery. Proc Eur Dial Transplant Assoc 20:587–592
Agarwal G, Vats HS, Raval AN, Yevzlin AS, Chan MR, Gimelli G (2013) Chronic total occlusion and successful drug-eluting stent placement in Takayasu arteritis-induced renal artery stenosis. Clin Med Res 11:233–236
Heidemann F, Kolbel T, Debus ES, Diener H, Carpenter SW, Rohlffs F, Tsilimparis N (2018) Renal function salvage after delayed endovascular revascularization of acute renal artery occlusion in patients with fenestrated-branched endovascular aneurysm repair or visceral debranching. J Endovasc Ther 25:466–473
Acknowledgements
We thank Roberto Patarca for his linguistic assistance during the preparation of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
This retrospective study was approved by the Institutional Review Board with waiver of informed consent.
Rights and permissions
About this article
Cite this article
Yang, M., Lin, L., Niu, G. et al. Successful endovascular treatment of chronic renal artery occlusion: a preliminary retrospective case series including 15 patients. Int Urol Nephrol 51, 285–291 (2019). https://doi.org/10.1007/s11255-018-02067-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11255-018-02067-0