Stent placement for renal arterial stenosis: Where do we stand? A meta-analysis

被引:285
作者
Leertouwer, TC
Gussenhoven, EJ
Bosch, JL
van Jaarsveld, BC
van Dijk, LC
Deinum, J
Man in't Veld, AJ
机构
[1] Erasmus Univ Rotterdam Ee 2312, Dept Cardiol, NL-3015 GE Rotterdam, Netherlands
[2] Erasmus Univ Rotterdam Ee 2312, Dept Radiol, NL-3015 GE Rotterdam, Netherlands
[3] Erasmus Univ Rotterdam Ee 2312, Dept Internal Med, NL-3015 GE Rotterdam, Netherlands
[4] Erasmus Univ Rotterdam Ee 2312, Dept Epidemiol & Biostat, NL-3015 GE Rotterdam, Netherlands
[5] Erasmus Univ Rotterdam Ee 2312, Interuniv Cardiol Inst Netherlands, NL-3015 GE Rotterdam, Netherlands
[6] Keio Univ, Dept Hlth Policy & Management, Tokyo, Japan
关键词
arteries; grafts and prostheses; hypertension; renovascular; renal arteries; stenosis or obstruction; transluminal angioplasty; stents and prostheses;
D O I
10.1148/radiology.216.1.r00jl0778
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
PURPOSE: To perform a meta-analysis of renal arterial stent placement in comparison with renal percutaneous transluminal angioplasty (PTA) in patients with renal arterial stenosis. MATERIALS AND METHODS: Studies dealing with renal arterial stent placement (14 articles; 678 patients) and renal PTA (10 articles; 644 patients) published up to August 1998 were selected. A random-effects model was used to pool the data. RESULTS: Renal arterial stent placement proved highly successful, with an initial adequate performance in 98% and major complications in 11%. The overall cure rate for hypertension was 20%, whereas hypertension was improved in 49%. Renal function improved in 30% and stabilized in 38% of patients. The restenosis rate at follow-up of 6-29 months was 17%. Stent placement had a higher technical success rate and a lower restenosis rate than did renal PTA (98% vs 77% and 17% vs 26%, respectively; P < .001). The complication rate was not different between the two treatments. The cure rate for hypertension was higher and the improvement rate for renal function was lower after stent placement than after renal PTA (20% vs 10% and 30% vs 38%, respectively; P < .001). CONCLUSION: Renal arterial stent placement is technically superior and clinically comparable to renal PTA alone.
引用
收藏
页码:78 / 85
页数:8
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