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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
Italian Journal of Vascular and Endovascular Surgery 2007 June;14(2):71-5
Use of cutting balloon angioplasty in the treatment of in-stent renal artery restenosis
Zaccaria A., Siani A., Siani L. M., Ricci B., Baldassarre E., Flaishman I., Schioppa A.
Department of Vascular Surgery S.Pietro FBF Hospital, Rome, Italy
Aim. The aim of this study is to assess the immediate and mid term results of cutting ballon angioplasty in the treatment of renal artery in-stent restenosis.
Methods. From January 2003 to December 2005, 16 patients affected by renal artery stenosis underwent 19 percutaneous transluminal angioplasty (PTA) and primary renal artery stent implantation. In 15 cases (78.9%) the cause for the stenosis was an atherosclerotic ostial plaque while in 4 cases dysplastic mediodistal lesions were present. The procedural success was achieved in all cases and no major or minor complications occurred . There was no perioperative mortality. In 4 cases (25%) a severe right in-stent restenosis occurred during the follow-up period. The mean time for in-stent restenosis following the primary procedure was 6 months. In one cases a surgical indication was preferred. In the other 3 cases a 4×100 mm cutting ballon angioplasty (CBA) was performed. Subsequent conventional PTA was attempted. The control angiogram showed satisfactory results and the pressure gradient across the in-stent stenosis was < 5 mmHg, indicating no significant residual stenosis.
Results. All the patients were followed-up by means of periodical echo color duplex scan for a mean follow-up of 9.7 months (min 5 - max 14 months). During the follow-up period no case of significant in-stent restenosis was observed.
Conclusion. In our experience, patients with renal artery in-stent restenosis can be treated successfully with CBA, with good mid-term results and stable renal function.