Purpose: To retrospectively evaluate the role of clinical and procedural factors in predicting in-stent restenosis in patients with renovascular disease treated by renal artery stenting.Methods: From 1995 to 2002, 147 patients underwent renal artery stenting for the treatment of significant ostial atherosclerotic stenosis. Patients underwent strict clinical and color-coded duplex ultrasound follow-up. Ninety-nine patients (111 stents), with over 6 months of continuous follow-up (mean 22 +/- 12 months, range 6-60 months), were selected and classified according to the presence (group A, 30 patients, 32 lesions) or absence (group B, 69 patients, 79 lesions) of significant in-stent restenosis. A statistical analysis was performed to identify possible preprocedural and procedural predictors of restenosis considering the following data: sex, age, smoking habit, diabetes mellitus, hypertension, serum creatinine, cholesterol and triglyceride levels, renal artery stenosis grade, and stent type, length and diameter.Results: Comparing group A and B patients (X-2 test), a statistically significant relation was demonstrated between stent diameter and length and restenosis: the risk of in-stent restenosis decreased when the stent was >= 6 mm in diameter and between 15 and 20 mm in length. This finding was confirmed by multiple logistic regression analysis. Stent diameter and length were proved to be significantly related to in-stent restenosis also when evaluating only patients treated by Palmaz stent (71 stents).Conclusion: Although it is based on a retrospective analysis, the present study confirms the importance of correct stent selection in increasing long-term patency, using stents of at least 6 mm in diameter and with a length of approximately 1520 mm.
|Autori:||VIGNALI C; BARGELLINI I; LAZZERESCHI M; CIONI R; PETRUZZI P; CARAMELLA D; PINTO S; NAPOLI V; ZAMPA V; BARTOLOZZI C|
|Titolo:||Predicitive factors of in-stent restenosis in renal artery stenting. A retrospective analysis|
|Anno del prodotto:||2005|
|Digital Object Identifier (DOI):||10.1007/s00270-04-0012-x|
|Appare nelle tipologie:||1.1 Articolo in rivista|