The Renal Angioplasty and Stenting


Assistant Professor of Radiology Interventional Radiologist Department of Radiology, Be-sat Hospital, AJA University of Medical Science, Tehran, iran



Percutaneous transluminal angioplasty (PTA) of the renal artery has become an increasingly widespread peripheral vascular intervention for the treatment of renovascular hypertension (HTN). Catheter-based procedures began in 1964 when Charles Dotter initially developed PTA for treating peripheral vascular atherosclerosis. Andreas Grüntzig revolutionized the technique in 1974 when he developed a soft, flexible, double- lumen balloon catheter for use in coronary arteries.
PTA has since rapidly evolved into a widely used, versatile, and dependable vascular interventional technique. Excellent results may be achieved in the renal arteries if patients are well selected and if experienced clinicians perform the procedure
Alone or in combination with stent implantation, PTRA is increasingly used as an alternative to surgical revascularization for the treatment of RAS, which may cause HTN or jeopardize renal function. Technical success is usually achieved in more than 85% of cases; the failure rate is 10%.
PTRA-related complications occur in 7% of patients . An overall benefit on BP control is observed in 20-40% of patients with atherosclerotic RAS (ARAS) and 60-70% of those with fibromuscular dysplasia (FMD; see Outcomes). Independent of etiology, PTRA appears to be technically effective in correcting RAS. However, its position with respect to medical or surgical treatment must be better defined through randomized controlled studies aimed at comparing the clinical efficacies of these approaches.