Objectives To evaluate if PTRAS in the elderly patients with atherosclerotic renal artery stenosis (ARAS) can have long-term effect on hypertension and renal function.
Methods To retrospectively collect the data of the elderly patients cases with ARAS diagnosed by angiography (stenosis≥70%). 65 PTRAS were performed. The average age of the group was 76.1±5 (67–88) years. The median follow-up was 30.9 months.
Results There were significant decrease in BP (before, 153.8±23.5/78.6±11.3 mm Hg vs after, 131.8±13.9/68.9±8.3 mm Hg; p<0.01)at the third day after PTRAS and the decrease of BP remained till 36 months after PTRAS. The mean number of antihypertensive drugs also decreased from 2.29±1.06 to 2.08±1.04. The incidence of Contrast-induced nephropathy was 9.2%. Logistic regression analysis showed that factors concerning complicated with diabetes mellitus, GFR≤30 ml/min/1.73 m2, systolic pressure ≥180 mm Hg and hydration therapy showed significant relationship with the incidence of CIN (p=0.0072; OR=13.51; p=0.0002; OR=519.27; p=0.0134; OR=13.16 and p=0.0266; OR=0.10; respectively). Renal function improved in 9.1%–15.8% of patients and was stabilised in 67.3%–55.3% of them and deteriorated in 23.4% –28.9% of patients in 12–36 months after PTRAS. Logistic regression analysis showed that patients with diabetes mellitus have more dangerous in the deterioration of renal function at 12 months after PTRAS (p=0.0277; OR=6.32). The restenosis rate was 13.8%.
Conclusion PTRAS could significantly decrease blood pressure level in the elderly patients with ARAS in 36 months after operation. The improvement of renal function in the elderly patients with ARAS after PTRAS is limit.