Results of renal artery revascularization in the post-ASTRAL era with 4 years mean follow-up
(2020) In Blood Pressure 29(5). p.285-290- Abstract
Purpose: To investigate contemporary results of percutaneous transluminal renal angioplasty (PTRA). Materials and Methods: A multicentre retrospective study analysing all patients treated with PTRA for primary symptomatic renal artery stenosis (RAS) between 2010 and 2013 at four tertiary centres. Procedures during the preceding four years were counted to evaluate for change in PTRA frequency. Results: The number of PTRA procedures decreased by approximately 50% from 2006 to 2013. Patients treated in the post-ASTRAL period (n = 224) had a significant reduction in mean systolic pressure (168 to 146 mmHg, p < 0.01), diastolic pressure (84 to 76 mmHg, p < 0.01), number of anti-hypertensive drugs (3.54 to 3.05, p < 0.01), and... (More)
Purpose: To investigate contemporary results of percutaneous transluminal renal angioplasty (PTRA). Materials and Methods: A multicentre retrospective study analysing all patients treated with PTRA for primary symptomatic renal artery stenosis (RAS) between 2010 and 2013 at four tertiary centres. Procedures during the preceding four years were counted to evaluate for change in PTRA frequency. Results: The number of PTRA procedures decreased by approximately 50% from 2006 to 2013. Patients treated in the post-ASTRAL period (n = 224) had a significant reduction in mean systolic pressure (168 to 146 mmHg, p < 0.01), diastolic pressure (84 to 76 mmHg, p < 0.01), number of anti-hypertensive drugs (3.54 to 3.05, p < 0.01), and anti-hypertensive treatment index (21.75 to 16.92, p < 0.01) compared to before PTRA. These improvements were maintained at one year and at the last clinical evaluation after a mean follow-up of 4.31 years. Renal function increased transiently without sustained improvement, or deterioration, during later follow-up. Thirteen patients (5.8%) eventually required dialysis, nine of these had eGFR <20 ml/min/1.73 m2 before PTRA. There was no difference in outcomes between subgroups differentiated by different indications for PTRA. Conclusion: The frequency of PTRA has decreased, indicating a higher threshold for invasive treatment of RAS in recent years. The reduction in blood pressures, the reduced need for anti-hypertensive medication, and stabilization of renal function over time suggest a clinical benefit for most patients who are now being treated with PTRA.
(Less)
- author
- publishing date
- 2020-05-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Hypertension, percutaneous transluminal renal angioplasty, PTRA, renal artery stenosis, renal insufficiency
- in
- Blood Pressure
- volume
- 29
- issue
- 5
- pages
- 285 - 290
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:85084300622
- pmid:32363961
- ISSN
- 0803-7051
- DOI
- 10.1080/08037051.2020.1756740
- language
- English
- LU publication?
- no
- id
- 0f7ce679-b963-45f1-85c9-019bff72569d
- date added to LUP
- 2020-05-26 09:05:49
- date last changed
- 2024-05-01 11:03:04
@article{0f7ce679-b963-45f1-85c9-019bff72569d,
abstract = {{<p>Purpose: To investigate contemporary results of percutaneous transluminal renal angioplasty (PTRA). Materials and Methods: A multicentre retrospective study analysing all patients treated with PTRA for primary symptomatic renal artery stenosis (RAS) between 2010 and 2013 at four tertiary centres. Procedures during the preceding four years were counted to evaluate for change in PTRA frequency. Results: The number of PTRA procedures decreased by approximately 50% from 2006 to 2013. Patients treated in the post-ASTRAL period (n = 224) had a significant reduction in mean systolic pressure (168 to 146 mmHg, p < 0.01), diastolic pressure (84 to 76 mmHg, p < 0.01), number of anti-hypertensive drugs (3.54 to 3.05, p < 0.01), and anti-hypertensive treatment index (21.75 to 16.92, p < 0.01) compared to before PTRA. These improvements were maintained at one year and at the last clinical evaluation after a mean follow-up of 4.31 years. Renal function increased transiently without sustained improvement, or deterioration, during later follow-up. Thirteen patients (5.8%) eventually required dialysis, nine of these had eGFR <20 ml/min/1.73 m<sup>2</sup> before PTRA. There was no difference in outcomes between subgroups differentiated by different indications for PTRA. Conclusion: The frequency of PTRA has decreased, indicating a higher threshold for invasive treatment of RAS in recent years. The reduction in blood pressures, the reduced need for anti-hypertensive medication, and stabilization of renal function over time suggest a clinical benefit for most patients who are now being treated with PTRA.</p>}},
author = {{Zachrisson, Karin and Krupic, Ferid and Svensson, Mikael and Wigelius, Ann and Jonsson, Andreas and Dimopoulou, Angeliki and Stenborg, Anna and Jensen, Gert and Herlitz, Hans and Gottsäter, Anders and Falkenberg, Mårten}},
issn = {{0803-7051}},
keywords = {{Hypertension; percutaneous transluminal renal angioplasty; PTRA; renal artery stenosis; renal insufficiency}},
language = {{eng}},
month = {{05}},
number = {{5}},
pages = {{285--290}},
publisher = {{Taylor & Francis}},
series = {{Blood Pressure}},
title = {{Results of renal artery revascularization in the post-ASTRAL era with 4 years mean follow-up}},
url = {{http://dx.doi.org/10.1080/08037051.2020.1756740}},
doi = {{10.1080/08037051.2020.1756740}},
volume = {{29}},
year = {{2020}},
}