The results of treatment in renal artery stenosis due to Takayasu disease: comparison between surgery, angioplasty, and stenting. A monocentrique retrospective study

To evaluate retrospectively and compare the long-term patency and the antihypertensive effect of open surgery, angioplasty, and stent insertion of the renal artery stenosis due to Takayasu's arteritis. We retrospectively analyzed and compared the effects on blood pressure and permeability of th...

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Bibliographic Details
Published in:Giornale di Chirurgia - Journal of Surgery 2015-07, Vol.36 (4), p.161-167
Main Authors: Kinjo, H, Kafa, A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Angioplasty
Female
Follow-Up Studies
Humans
Length of Stay
Male
Middle Aged
Original
Recurrence
Renal Artery Obstruction - diagnosis
Renal Artery Obstruction - etiology
Renal Artery Obstruction - surgery
Renal Artery Obstruction - therapy
Reoperation
Retrospective Studies
Risk Factors
Stents
Takayasu Arteritis - complications
Treatment Outcome
Vascular Surgical Procedures - methods
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Summary:To evaluate retrospectively and compare the long-term patency and the antihypertensive effect of open surgery, angioplasty, and stent insertion of the renal artery stenosis due to Takayasu's arteritis. We retrospectively analyzed and compared the effects on blood pressure and permeability of the renal artery over 23 patients (age ranging from 16 to 60 years, mean 33.9 years); with renovascular hypertension caused by Takayasu's arteritis. those patients underwent surgical treatment (11 arteries) or endovascular (19) including angioplasty (11) and stenting (8) for 30 stenotic renal arteries. Technical success was 96.7% (29/30) without major complications (but longer period of hospitalization among patients who had surgery). In the last follow-up CT angiography (mean 60 ± 36 months), restenosis was 18.2% (2/11) in the surgery, 9% (1/11) in the angioplasty, and 62.5% (5/8) in the stenting. Rate of the permeability of the surgery was 100%, 90.9% , 81.8%, the permeability of the angioplasty was 100%, 90.9%, 90.9%, primary patency rate stenting was 62.5%, 37.5%, 37.5%, assists permeability was 87.5%, 75%, 50% at 1, 3 and 5 years, respectively. In the clinical follow-up (mean 60 ± 37.8 months, range 48-96 months) beneficial effects on blood pressure were achieved into 91.3% of patients (21/23), and there was no significant difference between patients who have been treated by surgery and angioplasty alone and the patients who received a stent in at least one renal artery. Angioplasty has shown better long-term patency and a similar clinical benefit of renovascular hypertension in renal artery stenosis caused by Takayasu's arteritis compared with the surgery and the stenting. We suggest that stenting should be reserved in case of clear failure of the angioplasty. The surgery is our choice for patients who do not meet the indication of endovascular treatment or failure of this treatment.
ISSN:0391-9005
1971-145X
1971-145X
DOI:10.11138/gchir/2015.36.4.161