Safety and Efficacy of Carbon Dioxide and Intravascular Ultrasound-Guided Stenting for Renal Artery Stenosis in Patients With Chronic Renal Insufficiency

• Published in: Angiology 2015-03, Vol.66 (3), p.231-236
• Main Authors: Kawasaki, Daizo, Fujii, Kenichi, Fukunaga, Masashi, Fukuda, Nobuhisa, Masuyama, Tohru, Ohkubo, Nobukazu, Kato, Masaaki
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Angiography, Digital Subtraction - adverse effects; Angiography, Digital Subtraction - methods; Angioplasty - adverse effects; Angioplasty - instrumentation; Biomarkers - blood; Blood Pressure; Carbon Dioxide - adverse effects; Contrast Media - adverse effects; Creatinine - blood; Feasibility Studies; Female; Humans; Japan; Male; Middle Aged; Predictive Value of Tests; Radiography, Interventional - adverse effects; Radiography, Interventional - methods; Renal Artery Obstruction - blood; Renal Artery Obstruction - complications; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - physiopathology; Renal Artery Obstruction - therapy; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - physiopathology; Risk Factors; Stents; Time Factors; Treatment Outcome; Ultrasonography, Interventional - adverse effects
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319714524297

We evaluated the feasibility, safety, and mid-term outcomes of renal artery stenting using carbon dioxide (CO2) digital subtraction angiography and intravascular ultrasound (IVUS) for patients with renal insufficiency and significant atherosclerotic renal artery stenosis (RAS). Eighteen consecutive patients with chronic renal insufficiency underwent renal artery stenting under the guidance of CO2 angiography and IVUS without contrast media. Renal function and blood pressure were assessed pre- and postintervention. A total of 27 de novo RAS in 18 patients (15 males; mean age: 72 ± 9 years) with renal insufficiency were treated by renal artery stenting with the combined use of the CO2 angiography and IVUS without any procedural complications. Although the mean serum creatinine concentration preprocedure and 6 months after treatment did not change (2.7 ± 1.0-2.4 ± 1.1 mg/dL), blood pressure significantly decreased 6 months after stenting (158 ± 10-147 ± 11 mm Hg, P < .01).