Abstract
OBJECTIVES: Percutaneous transluminal renal angioplasty with stent implantation (PTRAS) has become the treatment of choice for atherosclerotic renal artery stenosis (ARAS). This study evaluates the long-term effects of PTRAS on hypertension and renal function in elderly patients with ARAS. METHODS: We conducted a retrospective cohort study of all patients who underwent PTRAS in the geriatric division of a tertiary medical center during the period 2003-2010. The clinical data were extracted from the medical records of each patient. Changes in blood pressure, antihypertensive treatment, and estimated glomerular filtration rate were analyzed before and after PTRAS. RESULTS: Eighty-six stents in 81 elderly patients were placed successfully. The average age of the patients was 76.2 years (65-89 years). Mean follow-up was 31.3 months (range 12 -49 months). There was a significant decrease in both systolic and diastolic blood pressure at the third day after the PTRAS procedure and the reduction in blood pressure was constant throughout the follow-up period until 36 months after PTRAS. However, there was no marked benefit to renal function outcome during the follow-up period. The incidence of contrast-induced nephropathy was 9.9% in this study group. The rate of renal artery restenosis was 14.8%. The survival rate was 96.3% for 4 years after the procedure. CONCLUSION: It is beneficial to control blood pressure in elderly patients with ARAS up to 36 months after a PTRAS procedure. However, their renal function improvement is limited.