No Clear Benefit to Renal Artery Stents
Medical therapy alone best option for renal artery stenosis, study suggestsPublish date: May 7, 2009
THURSDAY, May 7 (HealthDay News) -- Patients with renal artery stenosis do not benefit from renal artery stent placement and are at risk for procedure-related complications, according to a study published online on May 5 in the Annals of Internal Medicine.
Liesbeth Bax, M.D., of the University Medical Center Utrecht in the Netherlands, and colleagues conducted a study of 140 patients recruited from 10 centers across Europe. The patients had creatinine clearance of less than 80 mL/min per 1.73 m2 and 50 percent or greater atherosclerotic renal artery stenosis and were randomized to treatment with medical treatment and stenting or medical treatment alone.
Of the 64 patients assigned to the stenting group, 46 underwent the procedure, and 10 (16 percent) achieved a 20 percent or greater decrease in creatinine clearance versus 16 (22 percent) of the 76 patients assigned to medical care alone, the investigators found. There were two procedure-related deaths, one death secondary to an infected hematoma and one patient who required dialysis in the stent group, the researchers observed.
"We found no statistically significant difference in progression of renal failure over two years in the two groups, although our findings are compatible with both efficacy and harm and are therefore inconclusive," the authors write. "Our findings favor a conservative therapeutic approach to patients with atherosclerotic renal artery stenosis, focused on cardiovascular risk factor management without stenting."
The study was partially funded by Bayer BV, Cordis, and Pfizer BV. Several authors have a relationship with the pharmaceutical industry, including Pfizer.
http://www.modernmedicine.com/modernmedicine/Pathology/No-Clear-Benefit-to-Renal-Artery-Stents/ArticleNewsFeed/Article/detail/597133?contextCategoryId=40184FUL TEXT
http://www.annals.org/cgi/content/full/0000605-200906160-00119v1
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