Renal artery angioplasty and stent placement: Predictors of a favorable outcome

Mark W. Burket, Christopher J. Cooper, David J. Kennedy, Pamela S. Brewster, Gary M. Ansel, Joseph A. Moore, Jayanti Venkatesan, William L Henrich

Research output: Contribution to journalArticle

123 Citations (Scopus)

Abstract

Background: Renal artery stenosis is a common disorder and is an established cause of hypertension and renal insufficiency. Although treatment with renal artery stents has been shown to improve blood pressure and renal function for some patients, the patient population most likely to benefit is unknown. The current study was designed to determine which factors are predictive of improved blood pressure and renal function when patients with renal artery stenosis are treated with renal artery angioplasty and stent placement. Methods: In a prospective evaluation 127 consecutively enrolled patients with renal artery stenosis in 171 vessels were treated with angioplasty and intravascular stents. Blood pressure and serum creatinine concentration were measured before stent placement and during the follow-up period. Results: The mean length of the follow-up period was 15 ± 14 months. Mean systolic blood pressure improved among patients with hypertension (from 177 ± 26 mm Hg before stent placement to 151 ± 24 mm Hg 6 months after stent placement (P < .001). The greatest improvement occurred among those with the highest baseline systolic blood pressure. This beneficial effect on blood pressure was sustained for 3 years. Sex, age, diastolic blood pressure, number of vessels into which stents were placed, serum creatinine concentration, presence of bilateral disease, race, and severity of stenosis were not predictive of improved blood pressure. Mean creatinine concentration was not significantly changed for the group as a whole. A significant decrease in serum creatinine concentration occurred among 43% of patients with baseline renal insufficiency. None of the examined variables was predictive of improvement. Conclusions: Renal artery angioplasty and stent placement produced a significantly greater reduction in systolic blood pressure among patients with the highest baseline systolic blood pressure. Other examined variables were not predictive of a significant improvement in blood pressure. No examined variable was predictive of improved renal function. We concluded that management of renal artery stenosis with renal artery angioplasty and stent placement is most likely to result in significant improvement in systolic blood pressure among patients with the highest baseline systolic blood pressure.

Original languageEnglish (US)
Pages (from-to)64-71
Number of pages8
JournalAmerican Heart Journal
Volume139
Issue number1 I
StatePublished - 2000
Externally publishedYes

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Renal Artery
Angioplasty
Stents
Blood Pressure
Renal Artery Obstruction
Creatinine
Kidney
Renal Insufficiency
Serum
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Burket, M. W., Cooper, C. J., Kennedy, D. J., Brewster, P. S., Ansel, G. M., Moore, J. A., ... Henrich, W. L. (2000). Renal artery angioplasty and stent placement: Predictors of a favorable outcome. American Heart Journal, 139(1 I), 64-71.

Renal artery angioplasty and stent placement : Predictors of a favorable outcome. / Burket, Mark W.; Cooper, Christopher J.; Kennedy, David J.; Brewster, Pamela S.; Ansel, Gary M.; Moore, Joseph A.; Venkatesan, Jayanti; Henrich, William L.

In: American Heart Journal, Vol. 139, No. 1 I, 2000, p. 64-71.

Research output: Contribution to journalArticle

Burket, MW, Cooper, CJ, Kennedy, DJ, Brewster, PS, Ansel, GM, Moore, JA, Venkatesan, J & Henrich, WL 2000, 'Renal artery angioplasty and stent placement: Predictors of a favorable outcome', American Heart Journal, vol. 139, no. 1 I, pp. 64-71.
Burket MW, Cooper CJ, Kennedy DJ, Brewster PS, Ansel GM, Moore JA et al. Renal artery angioplasty and stent placement: Predictors of a favorable outcome. American Heart Journal. 2000;139(1 I):64-71.
Burket, Mark W. ; Cooper, Christopher J. ; Kennedy, David J. ; Brewster, Pamela S. ; Ansel, Gary M. ; Moore, Joseph A. ; Venkatesan, Jayanti ; Henrich, William L. / Renal artery angioplasty and stent placement : Predictors of a favorable outcome. In: American Heart Journal. 2000 ; Vol. 139, No. 1 I. pp. 64-71.
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abstract = "Background: Renal artery stenosis is a common disorder and is an established cause of hypertension and renal insufficiency. Although treatment with renal artery stents has been shown to improve blood pressure and renal function for some patients, the patient population most likely to benefit is unknown. The current study was designed to determine which factors are predictive of improved blood pressure and renal function when patients with renal artery stenosis are treated with renal artery angioplasty and stent placement. Methods: In a prospective evaluation 127 consecutively enrolled patients with renal artery stenosis in 171 vessels were treated with angioplasty and intravascular stents. Blood pressure and serum creatinine concentration were measured before stent placement and during the follow-up period. Results: The mean length of the follow-up period was 15 ± 14 months. Mean systolic blood pressure improved among patients with hypertension (from 177 ± 26 mm Hg before stent placement to 151 ± 24 mm Hg 6 months after stent placement (P < .001). The greatest improvement occurred among those with the highest baseline systolic blood pressure. This beneficial effect on blood pressure was sustained for 3 years. Sex, age, diastolic blood pressure, number of vessels into which stents were placed, serum creatinine concentration, presence of bilateral disease, race, and severity of stenosis were not predictive of improved blood pressure. Mean creatinine concentration was not significantly changed for the group as a whole. A significant decrease in serum creatinine concentration occurred among 43{\%} of patients with baseline renal insufficiency. None of the examined variables was predictive of improvement. Conclusions: Renal artery angioplasty and stent placement produced a significantly greater reduction in systolic blood pressure among patients with the highest baseline systolic blood pressure. Other examined variables were not predictive of a significant improvement in blood pressure. No examined variable was predictive of improved renal function. We concluded that management of renal artery stenosis with renal artery angioplasty and stent placement is most likely to result in significant improvement in systolic blood pressure among patients with the highest baseline systolic blood pressure.",
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AU - Burket, Mark W.

AU - Cooper, Christopher J.

AU - Kennedy, David J.

AU - Brewster, Pamela S.

AU - Ansel, Gary M.

AU - Moore, Joseph A.

AU - Venkatesan, Jayanti

AU - Henrich, William L

PY - 2000

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N2 - Background: Renal artery stenosis is a common disorder and is an established cause of hypertension and renal insufficiency. Although treatment with renal artery stents has been shown to improve blood pressure and renal function for some patients, the patient population most likely to benefit is unknown. The current study was designed to determine which factors are predictive of improved blood pressure and renal function when patients with renal artery stenosis are treated with renal artery angioplasty and stent placement. Methods: In a prospective evaluation 127 consecutively enrolled patients with renal artery stenosis in 171 vessels were treated with angioplasty and intravascular stents. Blood pressure and serum creatinine concentration were measured before stent placement and during the follow-up period. Results: The mean length of the follow-up period was 15 ± 14 months. Mean systolic blood pressure improved among patients with hypertension (from 177 ± 26 mm Hg before stent placement to 151 ± 24 mm Hg 6 months after stent placement (P < .001). The greatest improvement occurred among those with the highest baseline systolic blood pressure. This beneficial effect on blood pressure was sustained for 3 years. Sex, age, diastolic blood pressure, number of vessels into which stents were placed, serum creatinine concentration, presence of bilateral disease, race, and severity of stenosis were not predictive of improved blood pressure. Mean creatinine concentration was not significantly changed for the group as a whole. A significant decrease in serum creatinine concentration occurred among 43% of patients with baseline renal insufficiency. None of the examined variables was predictive of improvement. Conclusions: Renal artery angioplasty and stent placement produced a significantly greater reduction in systolic blood pressure among patients with the highest baseline systolic blood pressure. Other examined variables were not predictive of a significant improvement in blood pressure. No examined variable was predictive of improved renal function. We concluded that management of renal artery stenosis with renal artery angioplasty and stent placement is most likely to result in significant improvement in systolic blood pressure among patients with the highest baseline systolic blood pressure.

AB - Background: Renal artery stenosis is a common disorder and is an established cause of hypertension and renal insufficiency. Although treatment with renal artery stents has been shown to improve blood pressure and renal function for some patients, the patient population most likely to benefit is unknown. The current study was designed to determine which factors are predictive of improved blood pressure and renal function when patients with renal artery stenosis are treated with renal artery angioplasty and stent placement. Methods: In a prospective evaluation 127 consecutively enrolled patients with renal artery stenosis in 171 vessels were treated with angioplasty and intravascular stents. Blood pressure and serum creatinine concentration were measured before stent placement and during the follow-up period. Results: The mean length of the follow-up period was 15 ± 14 months. Mean systolic blood pressure improved among patients with hypertension (from 177 ± 26 mm Hg before stent placement to 151 ± 24 mm Hg 6 months after stent placement (P < .001). The greatest improvement occurred among those with the highest baseline systolic blood pressure. This beneficial effect on blood pressure was sustained for 3 years. Sex, age, diastolic blood pressure, number of vessels into which stents were placed, serum creatinine concentration, presence of bilateral disease, race, and severity of stenosis were not predictive of improved blood pressure. Mean creatinine concentration was not significantly changed for the group as a whole. A significant decrease in serum creatinine concentration occurred among 43% of patients with baseline renal insufficiency. None of the examined variables was predictive of improvement. Conclusions: Renal artery angioplasty and stent placement produced a significantly greater reduction in systolic blood pressure among patients with the highest baseline systolic blood pressure. Other examined variables were not predictive of a significant improvement in blood pressure. No examined variable was predictive of improved renal function. We concluded that management of renal artery stenosis with renal artery angioplasty and stent placement is most likely to result in significant improvement in systolic blood pressure among patients with the highest baseline systolic blood pressure.

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