Renal artery angioplasty

Technical results and clinical outcome in 320 patients

F. S. Bonelli, M. A. McKusick, Stephen C Textor, P. B. Kos, A. W. Stanson, C. M. Johnson, P. F. Sheedy, T. J. Welch, A. Schirger

Research output: Contribution to journalArticle

188 Citations (Scopus)

Abstract

Objective: To review the results of percutaneous transluminal renal artery angioplasty (PTRA), including technical success and clinical outcome, at Mayo Clinic Rochester. Design: We retrospectively reviewed our experience with 320 patients who underwent PTRA for stenosis of 396 arteries during a 14-year period. Material and Methods: We reviewed medical records and angiograms of patients who underwent PTRA at Mayo Clinic Rochester between January 1980 and December 1993. The patients were divided into four groups, based on clinical history and angiographic appearance of the stenosing lesion: renal artery atherosclerosis (ASO group), fibromuscular dysplasia (FMD group), previous renal artery bypass or endarterectomy, and renal artery stenosis in a solitary kidney. Technical results of the PTRA were determined by evaluation of angiograms obtained before and after the procedure. Data on patient demographics, blood pressure, antihypertensive medications, and serum creatinine were recorded for the period preceding PTRA, after the procedure, and at last follow-up. Results: All groups had statistically significant reductions in mean arterial pressure and antihypertensive medications after PTRA. The percentage of patients who benefited after renal artery angioplasty was 70% for patients with ASO (8.4% cured), 63% for patients with FMD (22% cured), 53.8% for patients with prior surgical revascularization (23.1% cured), and 91.7% for patients with a solitary kidney (0% cured). No significant overall change in serum creatinine level was noted after the procedure in any group. Complications were comparable to those reported in other studies. The 30-day all-cause mortality rate was 2.2% for the current study, all deaths occurring in the ASO group. Conclusion: PTRA rarely leads to a 'cure' of renovascular hypertension but provides effective control of blood pressure and decreases the medication requirements in selected patients.

Original languageEnglish (US)
Pages (from-to)1041-1052
Number of pages12
JournalMayo Clinic Proceedings
Volume70
Issue number11
StatePublished - 1995

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Renal Artery
Angioplasty
Renal Artery Obstruction
Antihypertensive Agents
Creatinine
Angiography
Fibromuscular Dysplasia
Blood Pressure
Kidney
Endarterectomy
Renovascular Hypertension
Serum
Medical Records
Atherosclerosis
Arterial Pressure
Arteries
Demography
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Bonelli, F. S., McKusick, M. A., Textor, S. C., Kos, P. B., Stanson, A. W., Johnson, C. M., ... Schirger, A. (1995). Renal artery angioplasty: Technical results and clinical outcome in 320 patients. Mayo Clinic Proceedings, 70(11), 1041-1052.

Renal artery angioplasty : Technical results and clinical outcome in 320 patients. / Bonelli, F. S.; McKusick, M. A.; Textor, Stephen C; Kos, P. B.; Stanson, A. W.; Johnson, C. M.; Sheedy, P. F.; Welch, T. J.; Schirger, A.

In: Mayo Clinic Proceedings, Vol. 70, No. 11, 1995, p. 1041-1052.

Research output: Contribution to journalArticle

Bonelli, FS, McKusick, MA, Textor, SC, Kos, PB, Stanson, AW, Johnson, CM, Sheedy, PF, Welch, TJ & Schirger, A 1995, 'Renal artery angioplasty: Technical results and clinical outcome in 320 patients', Mayo Clinic Proceedings, vol. 70, no. 11, pp. 1041-1052.
Bonelli FS, McKusick MA, Textor SC, Kos PB, Stanson AW, Johnson CM et al. Renal artery angioplasty: Technical results and clinical outcome in 320 patients. Mayo Clinic Proceedings. 1995;70(11):1041-1052.
Bonelli, F. S. ; McKusick, M. A. ; Textor, Stephen C ; Kos, P. B. ; Stanson, A. W. ; Johnson, C. M. ; Sheedy, P. F. ; Welch, T. J. ; Schirger, A. / Renal artery angioplasty : Technical results and clinical outcome in 320 patients. In: Mayo Clinic Proceedings. 1995 ; Vol. 70, No. 11. pp. 1041-1052.
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abstract = "Objective: To review the results of percutaneous transluminal renal artery angioplasty (PTRA), including technical success and clinical outcome, at Mayo Clinic Rochester. Design: We retrospectively reviewed our experience with 320 patients who underwent PTRA for stenosis of 396 arteries during a 14-year period. Material and Methods: We reviewed medical records and angiograms of patients who underwent PTRA at Mayo Clinic Rochester between January 1980 and December 1993. The patients were divided into four groups, based on clinical history and angiographic appearance of the stenosing lesion: renal artery atherosclerosis (ASO group), fibromuscular dysplasia (FMD group), previous renal artery bypass or endarterectomy, and renal artery stenosis in a solitary kidney. Technical results of the PTRA were determined by evaluation of angiograms obtained before and after the procedure. Data on patient demographics, blood pressure, antihypertensive medications, and serum creatinine were recorded for the period preceding PTRA, after the procedure, and at last follow-up. Results: All groups had statistically significant reductions in mean arterial pressure and antihypertensive medications after PTRA. The percentage of patients who benefited after renal artery angioplasty was 70{\%} for patients with ASO (8.4{\%} cured), 63{\%} for patients with FMD (22{\%} cured), 53.8{\%} for patients with prior surgical revascularization (23.1{\%} cured), and 91.7{\%} for patients with a solitary kidney (0{\%} cured). No significant overall change in serum creatinine level was noted after the procedure in any group. Complications were comparable to those reported in other studies. The 30-day all-cause mortality rate was 2.2{\%} for the current study, all deaths occurring in the ASO group. Conclusion: PTRA rarely leads to a 'cure' of renovascular hypertension but provides effective control of blood pressure and decreases the medication requirements in selected patients.",
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AU - Kos, P. B.

AU - Stanson, A. W.

AU - Johnson, C. M.

AU - Sheedy, P. F.

AU - Welch, T. J.

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