Article

Invasive treatment for renovascular disease. A twenty year experience from a population based registry.

Department of Surgical Sciences, Section of Surgery, Uppsala University Hospital Uppsala, Sweden.
The Journal of cardiovascular surgery (impact factor: 1.56). 10/2008; 49(5):559-63. pp.559-63
Source: PubMed

ABSTRACT To analyze time trends in invasive treatment of renovascular disease in one country.
Data have been analyzed from registrations in the Swedish Vascular Registry.
Invasive treatment for renovascular disease contributes around 1% of all vascular surgery within the Swedish Vascular Registry. Over the twenty-year period 1987-2006 the population-based frequency of invasive treatment for renovascular disease has increased; 1 597 procedures have been registered with an increase over time. The age of the treated patients has increased over the period (P<0.001). There has been a shift from open to endovascular procedure and from isolated percutaneous transluminal renal angioplasty (PTRA) to PTRA combined with a stent. Complications and mortality are significantly higher in patients undergoing open reconstruction (P<0.01). One year follow-up is incomplete and long-term results are therefore not possible to evaluate through registry-data only.
Using nation-wide registry data it is possible to analyze time-trends also concerning rare diseases or interventions. The changing pattern toward endovascular treatment of renovascular disease is obvious. Follow-up data at one year are incomplete.

0 0
 · 
0 Bookmarks
 · 
26 Views
  • Source
    Article: Outcome after endovascular revascularization of atherosclerotic renal artery stenosis.
    H Eklöf, D Bergqvist, A Hägg, R Nyman
    [show abstract] [hide abstract]
    ABSTRACT: With an aging population, more patients might be treated for atherosclerotic renal artery stenosis (ARAS). The goal of this treatment is to achieve a dialysis-free life or a well-controlled blood pressure with reduced risks of cardiovascular complications. To analyze the clinical outcome of percutaneous transluminal renal artery angioplasty without stenting (PTRA) or with stenting (PTRS) for ARAS at one center. The study group comprised 152 patients who underwent 203 PTRA/PTRS. All had hypertension, and 45% had azotemia. A retrospective collection of baseline and postprocedural number of antihypertensive drugs, blood pressure, and serum creatinine were analyzed during a follow-up of 3-18 months. Technical success rate was 95%, and clinical benefit was seen in 63% of patients. Complications included a 30-day mortality rate of 1.5%, a total complication rate of 35%, and major adverse events in 13%. The major adverse events were highly related to azotemia. Major adverse events within 30 days, with permanent disability, were seen in 5% and almost exclusively in patients with moderate or severe renal impairment. A subgroup analysis of 28 patients with renal duplex resistive index (RI) pre-PTRA/S and 6 months' follow-up showed a benefit of PTRA/PTRS in 17 (68%) of the 25 patients with RI <80 and in all three (100%) of the patients with RI >or=80. Endovascular treatment of ARAS has an excellent technical success rate, with a clinical improvement rate of >60%. However, it is associated with a considerable complication rate. Serious complications are seen mainly in azotemic patients. Predictors of clinical response could not be identified. Renal duplex RI is questioned as a predictor of clinical outcome.
    Acta Radiologica 02/2009; 50(3):256-64. · 1.37 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

changing pattern
 
Complications
 
endovascular procedure
 
endovascular treatment
 
Follow-up data
 
Invasive treatment
 
long-term results
 
nation-wide registry data
 
patients undergoing open reconstruction
 
percutaneous transluminal renal angioplasty
 
population-based frequency
 
rare diseases
 
registry-data
 
renovascular disease
 
renovascular disease contributes
 
Swedish Vascular Registry
 
time trends
 
time-trends
 
treated patients
 
vascular surgery