Purpose: To retrospectively evaluate the
results of renal artery stenting in patients with renovascular disease
and a solitary functioning kidney.
Methods: Palmaz
stents were placed in 16 patients with a solitary functioning kidney,
renal artery stenosis, hypertension and renal failure. Stenoses were
evaluated with color Doppler ultrasound, MR angiography and digital
subtraction angiography (DSA). Indications for stenting were: recoil
after percutaneous transluminal renal angioplasty (PTRA) (63%),
arterial dissection after PTRA (13%) and primary stenting (25%).
Immediate results were evaluated by DSA. On follow-up (6-36 months),
patients underwent periodical evaluation of clinical conditions (blood
pressure and serum creatinine level) and stent patency, by means of
color Doppler ultrasound.
Results: Stent placement
was successful in all patients (100%). Cumulative primary patency rate
was: 100% at 1 day, 93.75% at 6 months, 81.25% at 12 months and 75%
at 24 months. A significant reduction in diastolic blood pressure
occurred (mean ± SD 104 ± 6 vs 92 ± 3;
p < 0.05); renal function improved or stabilized in
over 80% of patients. However, there was no significant difference in
the creatinine values before and after treatment (mean ± SD
200 ± 142 mmol/l vs 197 ± 182 mmol/l; p
> 0.05).
Conclusion: Renal artery stenting, both after
PTRA and as primary stenting, represents a safe procedure, able to
preserve renal function in patients with a solitary functioning kidney.