Renal artery stent placement: complications at a single tertiary care center.
ABSTRACT To describe complications after renal artery stent placement in patients with atherosclerotic renal artery stenosis (RAS) at a single tertiary care center and analyze the risk factors for these complications.
Medical records and angiograms of 171 patients who underwent a total of 179 consecutive percutaneous transluminal renal artery stent placement (PTRS) procedures for atherosclerotic RAS were retrospectively reviewed. Data on patient comorbidities, procedure indication, lesion location, serum creatinine level, and procedure-related complications were analyzed. The Wilcoxon rank-sum test was used to assess the association of continuous risk factors with complications, and the chi(2) test was used to assess the association of categoric risk factors with outcomes.
The technical success rate for PTRS was 98%. Major complications included renal infarction in five patients (2.8%), permanently increased serum creatinine level in 10 patients (5.6%) that required hemodialysis in five (2.8%), blood transfusion in four patients (2.2%), surgical intervention for procedure-related complications in two patients (1.1%), and deep vein thrombosis in one patient (0.6%). Overall, major complications occurred in 15 procedures (8.4%). Death within 30 days after PTRS occurred in two patients (1.1%), but neither death was definitively caused by the procedure. No risk factors were found to be significantly (P <.05) associated with major complications. Patients with renal artery site or renal function complications tended to be older (P =.01) and have higher creatinine levels (P =.06).
Renal artery stent placement allows treatment of advanced atheromatous RAS in patients with significant medical and surgical comorbidities. Complications are frequent but few have long-term significance.
- Science. 298(2002):794-799.
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ABSTRACT: Regular aerosol extinction and backscatter measurements using a UV Raman lidar have been performed from January 2001 to December 2004 at Thessaloniki, Greece (40.5 N, 22.9 E), in the framework of the European Aerosol Research Lidar Network (EARLINET). Profiles of the aerosol extinction coefficient, backscatter coefficient, and extinction-to-backscatter ratio (so-called ‘‘lidar ratio’’) were acquired under nighttime conditions and have been used for statistical investigations. The statistical analysis was made both for the planetary boundary layer and for the free troposphere. It was found that the 4-year mean boundary layer particle optical depth at 355 nm was 0.44 ± 0.18, and the total aerosol optical depth was 0.63 ± 0.27. Free tropospheric particles account on the average for 30% of the total aerosol optical depth, ranging from 5% (clean free troposphere conditions) to 55% (mainly Saharan dust events). For the cases examined, the integral of the lidar-derived extinction coefficient was in good agreement with colocated aerosol optical depth measurements at 355 nm obtained with a Brewer spectroradiometer. The mean value of the lidar ratio at 355 nm derived, for the period of measurements at Thessaloniki, was 40 sr with a standard deviation of 21 sr. Mean height profiles of the particle lidar ratio, extinction, and backscatter coefficients are shown along with their seasonal dependence, showing a significant seasonal variability in the free troposphere. An analysis of the data using back trajectories showed also a dependence of the aerosol optical depth and the lidar ratio on the origin of the air mass, with higher values mostly corresponding to air masses originating from the northeast Balkans and eastern Europe.Journal of Geophysical Research 01/2005; 110(D21). · 3.17 Impact Factor
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ABSTRACT: 1] Dual-wavelength Raman lidar observations were regularly carried out at Leipzig (51.3°N, 12.4°E) from May to August 2003. The measurements showed that particle backscatter and extinction coefficients in the free troposphere were higher compared to values in 2000–2002. Backward dispersion modeling indicates that intense forest fires that occurred in Siberia and Canada in spring/summer 2003 were the main cause of these free tropospheric haze layers. Measurements on 3 days were selected for an optical and microphysical particle characterization of these well-aged particle plumes. Particle lidar ratios measured at 532 nm wavelength were higher than at 355 nm. This property seems to be a characteristic feature of aged biomass-burning particles observed over central Germany. Mean particle Å ngström exponents calculated for the wavelength range from 355 to 532 nm varied from 0 to 1.3. Particle effective radii varied between 0.24 and 0.41 mm. Pollution advected from North America on 25 August 2003, in contrast, was characterized by considerably smaller particles. Mean effective radii were 0.2 mm, and Å ngström exponents were 1.8–2.1. Lidar ratios in that case were lower at 532 nm compared to those at 355 nm. Such signatures are characteristic for anthropogenic particles. At the moment, however, it cannot be completely ruled out that extremely hot forest fires in western areas of Canada generated comparably small particles. Except for this specific case the forest fire particles were considerably larger than what is usually reported from in situ observations of biomass-burning smoke. Possible explanations for this difference could be the kind of burning process, which could generate much larger particles in the source region, condensation of organic vapors on existing particles, and coagulation processes during the long transport time of more than a week. Relative humidity measured in these layers was very low. Hygroscopic growth of the particles therefore seemed to have little influence on the size of the particles. The forest fire smoke consisted of moderately absorbing material. Real parts of the complex refractive index of the particles were mostly <1.5, and imaginary parts were <0.01i. Single-scattering albedo in all cases varied between 0.9 and 0.98 at 532 nm. Citation: Müller, D., I. Mattis, U. Wandinger, A. Ansmann, D. Althausen, and A. Stohl (2005), Raman lidar observations of aged Siberian and Canadian forest fire smoke in the free troposphere over Germany in 2003: Microphysical particle characterization,Journal of Geophysical Research 09/2005; 110. · 3.17 Impact Factor