A.Z. SHARAFEEV^1,2, A.F. KHALIRAKHMANOV², В.M. SHARAFUTDINOV², A.V. POSTNIKOV³.

¹Kazan State Medical Academy, 36 Butlerova St., Kazan, Russian Federation 420012

²Republican Clinical Hospital №2, 1a Chekhova Str., Kazan, Russian Federation 420012

³Republican Clinical Hospital of Ministry of Health of the Republic of Tatarstan, 138 Orenburgskiy trakt, Kazan, Russian Federation 420064

Sharafeev A.Z. — D. Med. Sc., Head of the Department of Cardiology, Endovascular and Cardiovascular Surgery, Head of the Department of angiographic and X-ray operation studies, tel. +7-927-410-93-89, e-mail: aidarch@mail.ru^1,2

Khalirakhmanov A.F. — Physician of the Department of angiographic and X-ray operation studies, tel. +7-929-722-33-34, e-mail: ai.bolit@mail.ru²

Sharafutdinov B.M. — Physician of the Department of angiographic and X-ray operation studies, tel. +7-927-404-24-99, e-mail: bulaty555@mail.ru²

Postnikov A.V. — operating surgeon of the room for angiography of the Department of X-ray and Surgery Diagnostic techniques and treatment, tel. +7-960-048-11-98, e-mail: sasha-postnikov@mail.ru³

Despite recent randomized trials, which have not defined benefits of kidney arteries stenting in comparison with medical therapy, the question of endovascular interventions still remains open. The article deals with topical issues of the renal arteries stenting with recent studies. There were analyzed two recent large randomized trials CORAL and ASTRAL published in 2013 and 2009, respectively. The clinical indications for renal arteries stenting were summarized.

Key words: renal artery stenting, indications, trials CORAL and ASTRAL.

 

 

REFERENCES

1. Sharafeev A.Z., Akberov R.F., Abashev A.R. et al. Immediate and long-term results of renal artery stenting in patients with atherosclerotic renovascular hypertension. Kazanskiy meditsinskiy zhurnal, 2008, pp. 113-117 (in Russ.).

2. Cooper C.J., Murphy T.P., Cutlip D.E. et al. Stenting and medical therapy for atherosclerotic renal-arterystenosis. N. Engl. J. Med., 2014, p. 370, 13–22.

3. Bax L., Woittiez A-J.J., Kouwenberg H.J. et al. Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial. Ann. Intern. Med., 2009, no. 150, pp. 840-848.

4. Levy M.S., Creager M.A. The ASTRAL Investigators. Revascularization vs medical therapy for renal-artery stenosis. N. Engl. J. Med., 2009, no. 361, pp. 1953-1962.

5. Wheatley K., Ives N., Gray R. et al. Revascularization versus Medical Therapy for Renal-Artery Stenosis. The ASTRAL Investigators. N. Engl. J. Med., November 12, 2009, no. 361 (20), pp. 1953-1962.

6. Zyatenkov A.V., Drapkina O.M., Ashikhmin Ya.I. Modern approaches to the diagnosis and treatment of renovascular hypertension. Rossiyskie meditsinskie vesti, 2010, no. 3, pp. 4-13 (in Russ.).

7. Balzer K.M., Pfeiffer T., Rossbach S. et al. Prospective randomized trial of operative vs interventional treatment for renal artery ostial occlusive disease (RAOOD). J. Vasc. Surg., 2009, no. 49, pp. 667-674.

8. Hirsch A.T., Haskal Z.J., Hertzer N.R. et al. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Associations for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (writing committee to develop guidelines for the management of patients with peripheral arterial disease) summary of recommendations. J. Vasc. Interv. Radiol., 2006, no, 17, pp. 1383-1397.

9. Galaria I.I., Surowiec S.M., Rhodes J.M. et al. Percutaneous and open renal revascularizations have equivalent long-term functional outcomes. Ann. Vasc. Surg., 2005, no. 19, pp. 218-228.

10. Kane G.C., Xu N., Mistrik E. et al. Renal artery revascularization improves heart failure control in patients with atherosclerotic renal artery stenosis. Nephrol. Dial. Transplant., 2010, no. 25, pp. 813-820.

11. Samuel J., Mann M., Thomas A. The Cardiovascular Outcomes in Renal Atherosclerotic Lesions Study and the Future of Renal Artery Stenting. The Journal of Clinical Hypertension. 2014, vol. 16, no. 3, pp. 162–165.

12. Imanishi M., Akabane S., Takamiya M. et al. Critical degree of renal arterial stenosis that causes hypertension in dogs. Angiology, 1992, no. 43, pp. 833-842.

13. Simon G. What is critical renal artery stenosis? Am. J. Hypertens., 2000, no. 13, pp. 1189-1193.

14. Gloviczki M.L., McKusick M.A., Glockner J.F. et al. Blood oxygen leveldependent magnetic resonance imaging identifies cortical hypoxia in severe renovascular disease. Hypertension, 2011, no. 58, pp. 1066-1072.

15. De Bruyne B., Manoharan G., Pijls N.H.J. et al. Assessment of renal artery stenosis severity by pressure gradient measurements. J. Am. Coll. Cardiol., 2006, no. 48, pp. 1851-1855.

16. Leesar M.A., Varma J., Shapira A. et al. Prediction of hypertension improvement after stenting of renal artery stenosis: comparative accuracy of translesional pressure gradients, intravascular ultrasound, and angiography. J. Am. Coll. Cardiol., 2009, no. 53, pp. 2363-2371.