›› 2011, Vol. 31 ›› Issue (7): 952-.doi: 10.3969/j.issn.1674-8115.2011.07.018

• Original article (Clinical research) • Previous Articles     Next Articles

Clinical efficacy of PTRAS in treatment of atherosclerotic renal artery stenosis

WU Sheng-jun1, ZHANG Lan1, ZHANG Ji-wei1, FANG Hua2, ZHANG Hao1, LIANG Wei1   

  1. 1.Department of Vascular Surgery, 2.Department of Ultrasound, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Online:2011-07-28 Published:2011-07-27
  • Supported by:

    Shanghai Municipal Health Bureau Foundation, 2008111

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Abstract:

Objective To evaluate the clinical efficacy of percutaneous transluminal renal artery stenting (PTRAS) in treatment of atherosclerotic renal artery stenosis (ARAS). Methods Twenty-eight patients with ARAS treated with PTRAS were divided into group A (50% to 75% of renal artery stenosis, n=10) and group B (≥75% of renal artery stenosis, n=18) according to the severity of renal artery stenosis. The success rate of surgery was obtained. Patients were followed up for 6 to 18 months, the obstruction status of renal arteries was examined, and the peak systolic velocity (PSV) of main renal arteries was measured after PTRAS by color Doppler ultrasound. Besides, the blood pressure and main parameters of renal function such as serum creatine (SCr) and glomerular filtration rate (GFR) were compared before and after treatment in two groups. Results PTRAS was successfully performed in 27 of the 28 patients, with the technical success rate of 96.43%. It was demonstrated by color Doppler ultrasound that the renal arteries were unobstructed, and PSV of main renal arteries significantly decreased after treatment (P<0.05). The systolic pressure significantly decreased, and the number of anti-hypertension medications significantly reduced in group A after PTRAS (P<0.05). There was no significant difference in blood pressure and number of anti-hypertension medications before treatment and after treatment in group B (P>0.05). The overall benefit rate of hypertension in group A was significantly higher than that in group B (P<0.05). After PTRAS, SCr significantly decreased, there was no significant change in GFR grading, and the overall benefit rate of renal function was 100% in group A. After PTRAS, there was no significant change in SCr, GFR grading significantly decreased, and the overall benefit rate of renal function was 81.25% in group B. Conclusion PTRAS is a minimally invasive method in treatment of ARAS, with less complications. Patients with ARAS and 50% to 75% renal artery stenosis may result in better control of blood pressure and stable renal function after treatment with PTRAS.

Key words: atherosclerosis, renal artery stenosis, renal artery stenting, renal function, hypertension