Lekston Andrzej, Chudek Jerzy, Gasior Mariusz, Wilczek Krzysztof, Wiecek Andrzej, Kokot Franciszek, Gierlotka Marek, Niklewski Tomasz, Fijałkowski Marek, Szyguła-Jurkiewicz Bozena, Wojnicz Roman, Białas Brygida, Osuch Marcin, Maciejewski Bogusław, Poloński Lech
Third Department of Cardiology, Silesian Center for Heart Disease, Zabrze, Poland.
Kidney Blood Press Res. 2008;31(5):291-8. doi: 10.1159/000153249. Epub 2008 Sep 5.
BACKGROUND/AIM: Scarce data exist concerning the long-term effect of renal balloon angioplasty (PTRA) enhanced by intravascular gamma-brachytherapy (IVBT) in patients with renovascular hypertension. The aim of this randomized study was to evaluate long-term outcome after PTRA with IVBT in patients with renal artery stenosis.
71 patients with renovascular hypertension were randomized into group I (PTRA + IVBT) or group II (PTRA). 9 patients who required stent implantation were excluded. Both baseline and 9-month follow-up quantitative computerized angiography and intravascular ultrasound (IVUS) analysis were performed to assess restenosis. During the 9-month follow-up, 3 patients died - 2 from group I and 1 from group II.
The restenosis rate was 16.1% in group I and 32.1% in group II. The 9-month lumen loss in angiography was 1.2 +/- 0.7 and 1.7 +/- 0.7 mm (p = 0.004) and the area loss (IVUS) was 6.5 +/- 4.8 and 10.1 +/- 5.6 mm(2) in groups I and II, respectively (p = 0.01). eGFR increased both in group I (from 75 +/- 22 to 84 +/- 31 ml/min/1.73 m(2); p < 0.001) and in group II (from 74 +/- 23 to 77 +/- 23 ml/min/1.73 m(2); p = 0.04). Only the diastolic blood pressure in group I decreased significantly (65 +/- 17 and 77 +/- 18 mm Hg; p = 0.048). The rate of blood pressure normalization was low in both groups (6.1 and 6.9%).
IVBT after PTRA with a self-centering source is a safe and effective method for prevention of restenosis in patients with renovascular hypertension.
