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Stent Placement in Ostial and Nonostial Atherosclerotic Renal Arterial Stenoses: A Prospective Follow-up Study¹

¹ From the Division of Angiology (I.B., K.v.A., D.D.D., M.B., F.M.) and the Department of Radiology (J.T.), University Hospital, Freiburgstrasse, 3010 Bern, Switzerland. Received June 30, 1999; revision requested August 16; final revision received November 26; accepted December 7. Address correspondence to I.B. (e-mail: iris.baumgartner@insel.ch).

PURPOSE: To compare the results of balloon percutaneous transluminal renal angioplasty (PTRA) and stent placement in atherosclerotic ostial, proximal, and isolated truncal stenoses.

MATERIALS AND METHODS: Between January 1994 and April 1998 the authors prospectively followed up 163 consecutive patients with 200 atherosclerotic renal arterial lesions after primary PTRA or primary stent placement. Duplex ultrasonography was performed 1 day and 3, 6, and 12 months later.

RESULTS: The primary 12-month PTRA patency rates were 34% (21 of 33 atherosclerotic lesions) for ostial stenoses, 65% (20 of 60) for proximal stenoses, and 83% (five of 30) for truncal stenoses (² value, 15.63; P < .001). The corresponding stent patency rates were 80% (four of 21), 72% (nine of 34), and 66% (five of nine), respectively (² value, 4.11; not significant). Significant stent-related reduction in risk of restenosis was limited to the ostial stenoses (P = .002).

CONCLUSION: Renal arterial stent placement considerably improves patency in ostial stenoses, but compared with the technically successful PTRA, it does not significantly improve primary patency in proximal and isolated truncal renal arterial stenoses.

Index terms: Renal angiography, 961.122 • Renal arteries, stenosis or obstruction, 961.721 • Renal arteries, transluminal angioplasty, 961.1282, 961.1286 • Renal arteries, US, 961.12989 • Stents and prostheses, 961.1268, 961.1286

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