Embolic Protection and Platelet Inhibition During Renal Artery Stenting

Preservation of renal function is an important objective of renal artery stent procedures. Although atheroembolization can cause renal dysfunction during renal stent procedures, whether adjunctive use of embolic protection devices or glycoprotein IIb/IIIa inhibitors improves renal function is unknow...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2008-05, Vol.117 (21), p.2752-2760
Main Authors: COOPER, Christopher J, HALLER, Steven T, VIRMANI, Renu, DIPPEL, Eric, ROCHA-SINGH, Krishna, MURPHY, Timothy P, KENNEDY, David J, SHAPIRO, Joseph I, D'AGOSTINO, Ralph D, PENCINA, Michael J, KHUDER, Sadik, COLYER, William, STEFFES, Michael, BURKET, Mark W, THOMAS, William J, SAFIAN, Robert, REDDY, Bhagat, BREWSTER, Pamela, ANKENBRANDT, Mary Ann
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Angioplasty
Antibodies, Monoclonal - administration & dosage
Biological and medical sciences
Blood and lymphatic vessels
Blood coagulation. Blood cells
Blood Pressure
Cardiology. Vascular system
Combined Modality Therapy
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Embolism - drug therapy
Embolism - prevention & control
Female
Fundamental and applied biological sciences. Psychology
Glomerular Filtration Rate
Hemorrhage
Humans
Immunoglobulin Fab Fragments - administration & dosage
Intraoperative Complications - prevention & control
Kidney Diseases - prevention & control
Male
Medical sciences
Middle Aged
Molecular and cellular biology
Platelet
Platelet Aggregation Inhibitors - administration & dosage
Prostheses and Implants
Prosthesis Implantation
Renal Artery - surgery
Renal Artery Obstruction - surgery
Stents
Treatment Outcome
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Summary:Preservation of renal function is an important objective of renal artery stent procedures. Although atheroembolization can cause renal dysfunction during renal stent procedures, whether adjunctive use of embolic protection devices or glycoprotein IIb/IIIa inhibitors improves renal function is unknown. One hundred patients undergoing renal artery stenting at 7 centers were randomly assigned to an open-label embolic protection device, Angioguard, or double-blind use of a platelet glycoprotein IIb/IIIa inhibitor, abciximab, in a 2x2 factorial design. The main effects of treatments and their interaction were assessed on percentage change in Modification in Diet in Renal Disease-derived glomerular filtration rate from baseline to 1 month using centrally analyzed creatinine. Filter devices were analyzed for the presence of platelet-rich thrombus. With stenting alone, stenting and embolic protection, and stenting with abciximab alone, glomerular filtration rate declined (P
ISSN:0009-7322
1524-4539
DOI:10.1161/CIRCULATIONAHA.107.730259