[Long-term follow-up of elderly patients with atherosclerotic renal artery stenosis treated by percutaneous transluminal angioplasty with stent implantation].

Objective: To evaluate the long-term effects of percutaneous transluminal renal angioplasty with stent (PTRAS) on hypertension and renal function in elderly patients with atherosclerotic renal artery stenosis (ARAS).

Methods: The data of elderly ARAS patients as diagnosed by angiography (stenosis ≥ 70%) were retrospectively collected. PTRAS was performed in 65 patients. The average follow-up period was 30.9 months.

Results: There were significant decrease in BP (blood pressure, mm Hg, 1 mm Hg = 0.133 kPa) (before: 154 ± 24/ 79 ± 119 vs after: 132 ± 14/69 ± 8; P < 0.01) at Day 3 post-PTRAS and the decrease of BP continued until 36 months after PTRAS. The average category of antihypertensive medication also decreased from 2.3 ± 1.1 to 2.1 ± 1.0. The incidence of contrast-induced nephropathy (CIN) was 9.2%. Logistic regression analysis showed that the factors of pre-operative diabetes mellitus, GFR ≤ 30 ml×min(-1)·1.73 m(-2), systolic pressure ≥ 180 mm Hg and hydration therapy had a significant relationship with the incidence of CIN (P = 0.0072; OR = 13.51; P = 0.0002; OR = 519.27; P = 0.0134; OR = 13.16 and P = 0.0266; OR = 0.10; respectively). Renal function improved in 9.1%-15.8% of patients, stabilized in 67.3% - 55.3% and deteriorated in 23.4% - 28.9% of patients at Months 12 - 36 post-PTRAS. Logistic regression analysis showed that the diabetics had a higher risk of deteriorating renal function at month 12 post-PTRAS (P = 0.0277; OR = 6.32). The restenosis rate was 13.8%.

Conclusion: PTRAS is beneficial in the control of blood pressure in elderly ARAS patients within 36 months after operation. The post-PTRAS improvement of renal function in elderly patients is limited.