Long-term Outcomes of Atherosclerotic Renovascular Disease in Patients Undergoing Angioplasty

Gerardo Nau, Mariano Albertal, Lucio Padilla, Jorge Thierer, Fernando Cura, Alfonsina Candiello, Matías Sztejfman, Jorge Belardi

Abstract


SUMMARY

The current increase in the diagnosis of atherosclerotic renovascular disease (ARD) befalls from the progressive recognition of its clinical impact. The role of percutaneous renal angioplasty as an alternative treatment has motivated, and continuous doing it, mainfold clinical trials.

Objective

To analyze a population submitted to percutaneous renal angioplasty and assess the safety of the procedure and the long-term clinical response.

Material and Methods

There were retrospectively and consecutively included 100 patients treated percutaneously. It was carried out a follow up by telephone calls or visits (median 1.7 years, interquartile range 25-75, 1.2 to 2.7 years) during which clinical and laboratory data was collected.

Results

A total of 100 patients were analyzed, mostly male (72%), mean age of 67.3 ± 9.9 years, with multiple cardiovascular risk factors (HBP 95%, DLP 74%, tobaccoism 63%, DM 28%) and extensive atherosclerotic vascular involvement (coronary disease 56%, peripheral vascular disease 39%). Stent angioplasty was carried out in 98% of cases, 22% bilaterally, with a success rate of 99%. It was observed a significant decrease in systolic blood pressure (SBP) at long-term follow-up (preprocedural SBT 139.7 ± 24.2mm Hg - postprocedural SBT 129.7 ± 13.9mm Hg, P <0.05), as well as a reduction in the number of indicated drugs (2.8 ± 1.03 - 1.7 ± 0.9, p = 0.02). These beneficial results were even higher in patients with bilateral involvement. Regarding renal function, 49% of patients showed sustained improvement (creatinine clearance: 53.6 ± 18.4 ml / min basal versus. 60.8 ± 19.5 ml / min at follow up, P = 0.011), whereas 20.4% showed a significant impairment in glomerular filtration. The improvement in glomerular filtration was more common in patients with advanced chronic impairment . (70.5% stages ≥III versus 13.5% stages 0-II; p=0.01) and with bilateral renal angioplasty (creatinine clearance: 52.8 ± 25.3 ml / min basal versus 66.1 ± 15.1 ml / min at follow-up; p = 0.032). In multivariate analysis, renal disease degree ≥III (OR29.6, CI95% 8.3 -105.8; p >0.001) and male sex (OR 16.2, CI 95% 4.3-105. 8: P> 0.001) were independent predictors of improvement in glomerular filtration rate at follow up.

 

Background


Full Text

Refbacks

  • There are currently no refbacks.


Licencia Creative Commons
The documents published in this journal are under the licencia Creative Commons Atribución-NoComercial-Compartir-Igual 2.5 Argentina.

Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar