P146 Analysis of Renal Artery Revascularization in a Tertiary Care Centre

Abstract

Renovascular hypertension is an uncommon cause of secondary hypertension. Percutaneous angioplasty is considered in selected patients. Retrospective study of patients undergoing renal artery revascularization, in a tertiary centre, in 2004–2017. Demographic, biometrical, radiological and clinical data were gathered. Sixty-one procedures were performed in 50 patients (42 adults). Most had Atherosclerotic Renal Artery Stenosis (ARAS) (n = 28, 56%), followed by Fibromuscular Dysplasia (FMD) (n = 14, 28%); 8 (16%) presented rare aetiologies. Patients were predominantly female (72%) irrespectively of the aetiology. Compared to FMD, patients with ARAS were older (63 ± 11 vs 35 ± 21 years, p < 0.001), and more often had dyslipidaemia (89.3% vs 42.9%, p = 0.002) and diabetes mellitus (39.3% vs 7.1%, p = 0.04). Most ARAS patients had stent placement (96.4%). Resistant hypertension (53.6%) and deteriorating renal function (32.1%) were the main causes for intervention. Concomitant peripheral artery disease and carotid atherosclerosis were reported in 39.3% and 46.4%, respectively. FMD was predominantly treated with balloon angioplasty (71.4%). Renovascular disease was multifocal in 71.1%. Supra-aortic and other abdominal aortic branches involvement was reported in 14.3% and 21.4%, respectively. Nine early complications (0.0% in ARAS, 25.0% FMD and 33.0% other aetiologies, p = 0.008) and 14 late complications (10.0% in ARAS, 31.3% FMD and 40.0% other aetiologies, p = 0.05) were reported, mainly residual stenosis and restenosis. Cure/improvement of hypertension occurred in 59.2% patients revascularized (66.7% in ARAS, 42.9% FMD and 62.5% other aetiologies, p = 0.33).

Our cohort was predominantly female. ARAS patients were older and had higher cardiovascular risk burden. There was a trend to less success in hypertension control improvement in FMD patients.