Document Detail


Preliminary study of the use of drug-eluting stents in atherosclerotic renal artery stenoses 4 mm in diameter or smaller.
MedLine Citation:
PMID:  18503896     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To describe restenosis and clinical outcomes with drug-eluting stents (DESs) and compare them to those of bare metal stents (BMSs) in the treatment of symptomatic atherosclerotic renal artery stenosis (RAS) in the same patients. METHODS AND MATERIALS: A retrospective study was performed of all patients with RAS treated with a DES (Taxus Express 2 or Cypher). DESs were used for RASs with luminal vessel diameters of 4 mm or smaller and BMSs were used for those larger than 4 mm. RESULTS: Sixteen patients (eight women; mean age, 72 years +/- 8) underwent treatment of 27 RASs for worsening renal function (n = 10) and uncontrolled hypertension (n = 6). Eighteen RASs were treated with 23 DESs (Cypher, n = 12; Taxus, n = 11) and nine were treated with BMSs. The average follow-up was 22 months +/- 10. After the procedure, the mean systolic blood pressure decreased significantly (P < .05), with no change in the mean diastolic pressure, serum creatinine, or number of antihypertensive medications. By Kaplan-Meier estimates, the 1- and 2-year patency rates for DESs were 78% and 68%, respectively; and for BMSs, the respective rates were 58% and 47% (P = NS). The average diameters of RASs were 3.4 mm +/- 0.6 in the DES group and 5.3 mm +/- 0.6 in the BMS group (P < .05). There were two technical failures (7.7%) in the DES group. There was one minor complication and a non-flow-limiting dissection. CONCLUSIONS: DESs were used to treat RASs with good technical results and low restenosis rates compared with BMSs despite the smaller artery diameters in the DES group.
Authors:
Sanjay Misra; Mallik R Thatipelli; Patrick W Howe; Christopher Hunt; Verghese Mathew; Gregory W Barsness; Axel Pflueger; Stephen C Textor; Haraldur Bjarnason; Michael A McKusick
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-04-28
Journal Detail:
Title:  Journal of vascular and interventional radiology : JVIR     Volume:  19     ISSN:  1051-0443     ISO Abbreviation:  J Vasc Interv Radiol     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203369     Medline TA:  J Vasc Interv Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  833-9     Citation Subset:  IM    
Affiliation:
Department of Radiology, Mayo Clinic College of Medicine, 200 First Street Southwest, Alfred 6460, Rochester, MN 55905, USA. misra.sanjay@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography
Drug-Eluting Stents*
Female
Gadolinium DTPA / diagnostic use
Humans
Immunosuppressive Agents / administration & dosage*
Male
Middle Aged
Paclitaxel / administration & dosage*
Proportional Hazards Models
Recurrence
Renal Artery Obstruction / drug therapy*,  radiography,  ultrasonography
Retrospective Studies
Sirolimus / administration & dosage*
Stents
Treatment Outcome
Tubulin Modulators / administration & dosage*
Vascular Resistance
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Tubulin Modulators; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus; 80529-93-7/Gadolinium DTPA

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