CHICAGO, Ill. (April 1, 2008) The largest-ever randomized study to evaluate the effectiveness of catheter-based interventions in patients with narrowing of the renal artery has shown that angioplasty and stenting offer no benefit over medical therapy. Among patients who completed one year of follow-up, there were no differences in the change in kidney function, blood pressure control or the rates of major cardiovascular illness, according to the Angioplasty and Stenting for Renal Artery Lesions (ASTRAL) trial.
The ASTRAL trial is being reported today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).
The study also found that 3 percent of patients who underwent renal artery intervention experienced a serious procedural complication, including poorly positioned stents and perforation and dissection of the renal artery.
For 15 years weve had the wherewithal to fix renal artery stenosis and restore patency of the renal artery, said Philip A. Kalra, MD, a consultant nephrologist at Hope Hospital, Salford, and lecturer at the University of Manchester, both in the United Kingdom. Thousands of patients have had this procedure, but no one has ever demonstrated any benefit in randomized control trial testing.
About 7 percent of people over age 65and about 10 percent of people with chronic kidney disease who eventually need dialysishave narrowing, or stenosis, of the renal artery. There are several links between renal artery stenosis and cardiovascular disease. For example, in nine out of 10 cases renal artery stenosis is caused by the build-up of atherosclerotic plaque. Many patients with renal artery stenosis also have
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