Renal embolic protection devices improve blood flow after stenting for atherosclerotic renal artery stenosis

Paul, Timir K., Lee, John H. and White, Christopher J. (2012) Renal embolic protection devices improve blood flow after stenting for atherosclerotic renal artery stenosis. Catheterization and Cardiovascular Interventions, 80 6: 1019-1022. doi:10.1002/ccd.24289


Author Paul, Timir K.
Lee, John H.
White, Christopher J.
Title Renal embolic protection devices improve blood flow after stenting for atherosclerotic renal artery stenosis
Journal name Catheterization and Cardiovascular Interventions   Check publisher's open access policy
ISSN 1522-1946
1522-726X
Publication date 2012-11-01
Sub-type Article (original research)
DOI 10.1002/ccd.24289
Volume 80
Issue 6
Start page 1019
End page 1022
Total pages 4
Place of publication Hoboken, NJ United States
Publisher John Wiley and Sons
Collection year 2013
Language eng
Formatted abstract
Objectives We sought to measure angiographic renal frame counts (RFC), as a quantitative angiographic assessment of renal blood flow, to evaluate microvascular compromise due to atheroembolism associated with RAS.
Background Atheroembolism associated with renal artery stenting (RAS) has been implicated as a cause for worsening renal function following successful intervention. Use of a distal embolic protection device (EPD) during RAS has been shown to be safe with debris capture in a high percentage of cases. However, objective benefit for renal function with EPD has been difficult to demonstrate.
Methods
A control group of 30 consecutive patients (33 kidneys) who underwent RAS without EPD were compared with 33 consecutive patients (33 kidneys) who underwent RAS with EPD using RFC measurement.
Results
The prestent and poststent mean RFC for the control group was 30.4 ± 12.1 vs. 23.7 ± 9.9 (P = 0.002) and for the EPD group it was 42.6 ± 12.6 vs. 28.3 ± 9.2 (P < 0.0001). The EPD group had a greater improvement in renal blood flow, manifested by a greater reduction of the RFC (Δ RFC) 14.2 ± 15.2 vs. 6.7 ± 11.7 (P = 0.03) compared with the control group.
Conclusions
The use of an EPD was associated with a much larger improvement in renal blood flow (lower RFC) following RAS. This suggests that EPD's may be effective in preventing renal atheroembolic injury and that a controlled trial measuring the impact of EPD's on renal blood flow following RAS should be performed.
Keyword Renal artery stenosis
Percutaneous renal artery stenting
Renal frame count
Renovascular hypertension
Renal Function
Frame Count
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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