Preliminary Study of the Use of Drug-eluting Stents in Atherosclerotic Renal Artery Stenoses 4 mm in Diameter or Smaller

Sanjay Misra, Mallik R. Thatipelli, Patrick W. Howe, Christopher Hunt, Verghese Mathew, Gregory W. Barsness, Axel Pflueger, Stephen C. Textor, Haraldur Bjarnason, Michael A. McKusick

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27 Scopus citations

Abstract

Purpose: To describe restenosis and clinical outcomes with drug-eluting stents (DESs) and compare them to those of bare metal stents (BMSs) in the treatment of symptomatic atherosclerotic renal artery stenosis (RAS) in the same patients. Methods and Materials: A retrospective study was performed of all patients with RAS treated with a DES (Taxus Express 2 or Cypher). DESs were used for RASs with luminal vessel diameters of 4 mm or smaller and BMSs were used for those larger than 4 mm. Results: Sixteen patients (eight women; mean age, 72 years ± 8) underwent treatment of 27 RASs for worsening renal function (n = 10) and uncontrolled hypertension (n = 6). Eighteen RASs were treated with 23 DESs (Cypher, n = 12; Taxus, n = 11) and nine were treated with BMSs. The average follow-up was 22 months ± 10. After the procedure, the mean systolic blood pressure decreased significantly (P < .05), with no change in the mean diastolic pressure, serum creatinine, or number of antihypertensive medications. By Kaplan-Meier estimates, the 1- and 2-year patency rates for DESs were 78% and 68%, respectively; and for BMSs, the respective rates were 58% and 47% (P = NS). The average diameters of RASs were 3.4 mm ± 0.6 in the DES group and 5.3 mm ± 0.6 in the BMS group (P < .05). There were two technical failures (7.7%) in the DES group. There was one minor complication and a non-flow-limiting dissection. Conclusions: DESs were used to treat RASs with good technical results and low restenosis rates compared with BMSs despite the smaller artery diameters in the DES group.

Original languageEnglish (US)
Pages (from-to)833-839
Number of pages7
JournalJournal of Vascular and Interventional Radiology
Volume19
Issue number6
DOIs
StatePublished - Jun 1 2008

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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