Renal artery stent placement: complications at a single tertiary care center.

Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Journal of Vascular and Interventional Radiology (Impact Factor: 2.15). 03/2003; 14(2 Pt 1):217-25. DOI: 10.1097/01.RVI.0000058324.82956.2a
Source: PubMed

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.

  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Renal artery stenosis is a cause of secondary hypertension which can be cured by surgical or radiological intervention such as percutaneous transluminal renal artery stent placement. In this case we present a subcapsular hematoma of the kidney, a complication following percutaneous transluminal stent placement in the renal artery. Reperfusion injury to the kidney may be a possible mechanism of subcapsular hematoma of the kidney. Long standing severe renal artery stenosis and high pre- and post-procedure pressure gradient might contribute to the complication.
    Electrolyte & blood pressure: E & BP 12/2007; 5(2):136-9.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent technological advances in the diagnosis and therapy of abdominal aortic aneurysm and renovascular disease are continuing to bring about changes in the way patients suffering from these conditions are treated. The prevalence of both these conditions is increasing. This is due to greater life-expectancy in patients with arteriosclerosis, a pathogenetic factor underlying both conditions. The application of diagnostic imaging techniques to non-vascular conditions has led to the early diagnosis of abdominal aortic aneurysm. Clinical suspicion of reno-vascular disease can be confirmed easily using high-resolution diagnostic imaging modalities such as CT angiography and magnetic resonance angiography. Endovascular intervention is successfully replacing conventional surgical repair techniques, with the result that it may be possible to improve outcome in both conditions using effective and minimally invasive approaches. Future technological developments will enable these endovascular techniques to be applied in the large majority of patients with abdominal aortic aneurysm or renovascular disease.
    Revista Espa de Cardiologia 06/2007; 60(6):639-654. · 3.34 Impact Factor