Study Evaluates Treatment of In-Stent Restenosis in Patients With Renal Artery Stenosis
August 10, 2016—Edwin A. Takahashi, MD, et al published findings from a study conducted to determine clinical outcomes of the treatment of patients for renal artery in-stent restenosis (ISR) with atherosclerotic renal artery stenosis. The study is available online ahead of print in the Journal of Vascular and Interventional Radiology (JVIR).
The investigators performed a retrospective review of the clinical data of all patients who underwent renal artery stent placement for atherosclerotic renal artery stenosis from 1996 to 2009. Medical records of patients were reviewed for relevant clinical history, including blood pressure, antihypertensive medications, and renal function data before and after an intervention.
As summarized in JVIR, there were 1,090 renal artery stent placements performed in 1,052 patients. In these procedures, 101 stents in 79 patients developed ISR that was treated with either percutaneous transluminal angioplasty (PTA) or repeat stent placement. The investigators recorded the procedural details, including modality of intervention, stent diameter, and time to restenosis along with the hypertensive agent and use of statins. Univariate analysis was performed to identify risk factors associated with restenosis after treatment of ISR.
Patients treated with repeat stent placement were 6.89 times more likely to lose patency after treatment than patients treated with PTA (P < .01). No additional clinical or procedural factor, including smoking history, presence of cardiac, renal, or metabolic disease, use of statin at time of ISR treatment, or diameter of treatment (stent or PTA) had a significant association with duration of stent or angioplasty patency.
Treatment of renal artery ISR with PTA among patients with atherosclerotic renal artery stenosis has a lower rate of subsequent ISR compared with repeat stent placement, concluded the investigators in JVIR.