Embolic Device Protects Kidney During Angioplasty

Short-term renal function after renal angioplasty and stenting performed with distal embolic protection (DEP) approaches that achieved with surgical revascularization, according to a new study.

Researchers at Wake Forest University Baptist Medical Center (Winston-Salem, NC, USA) conducted a retrospective study of percutaneous transluminal angioplasty and stenting of renal artery (RA-PTAS) procedures using DEP over a period of almost two years. The study group comprised 15 women and 11 men with a mean age of 71 years. Preoperatively, all had severe hypertension and 92% had moderate-to-severe renal insufficiency. A total of 32 RA-PTAS procedures using DEP were performed in the 26 patients. At four to six weeks, there was significant improvement in estimated glomerular filtration rate (eGFR) and blood pressure. Renal function was improved in 53% of the procedures and worsened in none. The study appeared in the July 2006 issue of the Journal of Vascular Surgery.

"These results approximate those achieved with surgical revascularization in the short term,” said lead author Matthew S. Edwards, M.D. "We think the nature of surgery protects against this type of embolic damage. The angioplasty results were drastically improved over what we were used to seeing--only 20% to 25% of people with a short-term improvement in renal function. We saw improvement in 53% of cases, actually getting into the neighborhood of what we see with surgery.”

The researchers hypothesized that liberation of debris occurred during angioplasty and stenting, and that the debris then traveled out and damaged the kidney. To prevent this, they used a DEP device consisting of a balloon system that temporarily blocks the vessel and a suction system that aspirates the debris.





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