1Rim Miri, 1Sobhi Mleyhi, 1Melek Ben Mrad, 2Imtinene Ben Mrad, 2Ihsene Zairi, 1Mohammed Ben Hammamia, 1Raouf Denguir

1Cardio-Vascular Surgery Department, Rabta Hospital, Tunis, Tunisia; 2Cardiology Department, Habib Thameur Hospital, Medical University of Tunis, Tunis El Manar UNiversity, Tunis, Tunisia

Background:

Renal artery stenosis(RAS) may be symptomatic. The treatment of these lesions is primarily medical but may sometimes require surgical or endovascular revascularization. RAS angioplasty is well controlled but its results are discussed. The objective of this work was to report the short- and long-term results of the endovascular treatment of renal arteries in our center.

Material(s) and Method(s):

We report a retrospective study, between 2013 and 2018, including patients who had endovascular treatment of severe symptomatic RAS (≥ 75%).

Result(s):

Our population consisted of 17 patients. Mean age was 51.1 years [18-76], sex ratio 2.4. RAS’s reason of discovery was severe renovascular hypertension resistant to medical treatment for 16 patients and a rapidly progressive renal failure for one patient. The retained etiology was: atherosclerosis (9 cases), fibromuscular dysplasia (6 cases) and Takayasu’s disease (2 cases). The average stenosis rate was 85.9% [75% -97%.]. We performed a simple angioplasty in 47% of the cases and a stenting in 53%. The technical success rate was 100%. At 1 month, morbidity-mortality rates were zero. Mean follow-up was 12 months [6-36months]. Patients with renovascular hypertension experienced a decrease in blood pressure, with discontinuation of antihypertensive therapy in 62.5% of cases and reduction of doses in 37.5% of cases. The permeability rate was 100% at 1 year, 94% at 2 years and 94% at 3 years. One patient had asymptomatic stent thrombosis at the 18th month. The restenosis rate was zero.

Conclusion(s):

Angioplasty of symptomatic RAS may be indicated as first line. This treatment is associated with satisfactory results in the short and long terms