Treatment of atheromatous renal artery in-stent restenosis in 51 patients - 05/01/13
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Abstract |
Objective |
To evaluate our treatment of renal artery in-stent restenosis.
Patients and methods |
Monocentric retrospective study of 53 cases of restenosis and two occlusions in 51 patients detected via systematic follow-up with imaging (72.5%) and/or deterioration of kidney function (5.9%) and/or blood pressure failure (54.9%), 15.7 months (5–121) after implantation, giving rise to 49 recalibrations via a balloon and five additional stentings. Analysis of the technical results, the effects on blood pressure and kidney function after repeated revascularizations.
Results |
Secondary permeability of 38 arteries (63.2%) after 12.4 months (3–64) with 14 second restenoses; 33.3% after redilation with a balloon, 60% after renewed stenting, more common in smokers (P=0.02), in case of peripheral arterial disease (P=0.02), ostial location (P=0.049) and kidney function impairment at the time of diagnosis of the restenosis (P=0.012). After 12.7 months (3–64) post-revascularization, kidney function was improved in 30% of patients and stabilised in 50% of patients. Treatment of second restenoses: one failure (7.1%), nine dilations with a balloon, three cutting balloon, one second stent. Treatment of third restenoses: 71.4% treated with a balloon (2), cutting balloon (2) or coated stent (DES) (1); then permeability at a later point in time: 50%.
Conclusion |
The treatment of repeated restenoses with conventional techniques is of imperfect efficacy, and currently remains un-codified.
Le texte complet de cet article est disponible en PDF.Keywords : Renal artery stenosis, In-stent restenosis, Endoprosthesis, Stent, Repeat angioplasty
Plan
Vol 94 - N° 1
P. 68-77 - janvier 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.