Immediate results of endovascular correction of renal artery stenosis
DOI: https://dx.doi.org/10.18565/nephrology.2019.3.25-30
D.Yu. Popov, S.I. Solodushkin, A.G. Stolyar, L.A. Shardina, S.A. Shardin
1) Ural State Medical University, Department of Nursing Management; Yekaterinburg, Russia
2) Ural Federal University named after the First President of Russia B.N. Yeltsin, Department of Computational Mathematics and Computer Science; Yekaterinburg, Russia
3) Sverdlovsk Regional Clinical Hospital № 1, Nephrology Department; Yekaterinburg, Russia
Objective. Evaluation of the immediate clinical results of endovascular correction of renal artery stenosis (ECRAS).
Material and methods. The immediate results of ECRAS were analyzed in 121 patients who underwent 147 interventions. All patients had arterial hypertension (AH), which was diagnosed in accordance with WHO recommendations (1999), and chronic kidney disease (CKD). CKD stage was assessed by glomerular filtration rate using the CKD-EPI formula. A period of 30 days was chosen as the immediate postoperative period. The results of ECRAS were evaluated at 3 and 30 days after the intervention. Efficiency of stent functioning or renal artery patency after angioplasty was analyzed, and serum creatinine (Cr) and blood pressure (BP) levels were compared before and after ECRAS. Assessment of the functional state (patency) of the stent after the intervention was carried out by ultrasound dopplerography.
Results. 3 and 30 days after the intervention, deaths and postoperative complications were not recorded. All ECRAS procedures were effective. The average Cr level in the study group significantly decreased by 7.48 μmol/L after 3 days and by 10.84 μmol/L 30 days after ECRAS (Wilcoxon test; p<0.001), as well as by 3.08 μmol/L after 30 days compared with the result on day 3 after ECRAS (Wilcoxon test; p<0.001). Blood pressure level statistically significantly decreased after ECRAS (Wilcoxon test; p<0.001; sign test; p<0.001).
Conclusion. ECRAS is a safe intervention for the life of patients in the immediate postoperative period. The ECRAS method is highly effective in restoring and maintaining renal artery patency. The clinical efficacy of ECRAS consists both in maintaining and improving renal function, and in correcting the severity of hypertension.
Keywords: renal artery, stenosis, atherosclerosis, stenting, angioplasty
About the Autors
Dmitry Yu. Popov – Senior Lecturer at the Department of Nursing Management, Ural State Medical University; Yekaterinburg, Russia. E-mail: dp.usmu@yandex.ru, ORCID ID: 0000-0002-0965-396X
Svyatoslav I. Solodushkin – PhD in Physical and Mathematical Sciences, Associate Professor, Senior Researcher at the Department of Computational Mathematics and Computer Science, Ural Federal University named after the First President of Russia B.N. Yeltsin; Yekaterinburg, Russia. E-mail: solodushkin_s@mail.ru, ORCID ID: 0000-0002-1959-5222
Aleksey G. Stolyar – Doctor of Medical Sciences, Head of the Nephrology Department, Sverdlovsk Regional Clinical Hospital №. 1; Yekaterinburg, Russia.
E-mail: ambr375@mail.ru, ORCID ID: 0000-0002-2485-9464
Lyubov A. Shardina – Doctor of Medical Sciences, Professor at the Department of Nursing Management, Ural State Medical University; Yekaterinburg, Russia.
ORCID ID: 0000-0002-2805-863X
Stanislav A. Shardin – Doctor of Medical Sciences, Professor, Department of Nursing Management, Ural State Medical University; Yekaterinburg, Russia.
ORCID ID: 0000-0002-7174-1768