Ostial renal artery stenosis angioplasty: Immediate and mid-term angiographic and clinical results

PURPOSE: To report the immediate results and the clinical and angiographic outcome of percutaneous angioplasty in patients with ostial renal artery stenosis. MATERIAL AND METHODS: Retrospective review of 52 percutaneous transluminal renal angioplasty (PTRA) procedures for strictly defined ostial atherosclerotic renal artery stenosis in 50 consecutive patients, selected among 670 PTRAs performed between 1983 and 1993. RESULTS: Immediate angiographic success was achieved in 30 arteries (58%) and improvement was achieved in 15 arteries (29%), The procedure was a failure in seven lesions (13%), PTRA was followed by a stent implantation in three lesions (6%), Two patients (4%) died within the first month after PTRA and a major complication occurred in seven other patients (13%). At a mean follow-up of 20.6 months, both systolic and diastolic blood pressure decreased significantly (P = .0006 and P = .0057 respectively), Renal function did not change significantly (P = .73), One patient was lost during follow-up, At angiographic control (mean, 11 months), restenosis occurred in 27% of the cases, There was no recurrence of pulmonary edema at a mean follow-up of 32 months in 50% of the 12 patients who experienced one episode or more before PTRA. CONCLUSIONS: True ostial renal artery stenosis is rare and often reflects severe and multifocal atheromatous disease, In these patients, PTRA might be considered an acceptable and relatively safe treatment that improves blood pressure and stabilizes renal function.