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Angioplasty may Damage Kidneys

Researchers from Wake Forest University Baptist Medical Center and colleagues has found that angioplasty-the most common procedure for clearing blocked kidney arteries can also release thousands of tiny particles into the bloodstream that can impair kidney function.

This is the first data in humans to show that debris released during angioplasty and stenting of the kidney arteries can be harmful to kidney function, said Matthew Edwards, M.D., M.S., lead researcher and an assistant professor of surgery. It raises important questions about how to most safely perform this very common procedure.

Edwards said that understanding more about potential complications from the procedure can lead to improved treatments. The study, reported in the current issue of the Journal for Vascular Surgery, suggests that having patients stop aspirin use before the procedure may lead to worse results.

It also shows that stent size is important and raises questions about whether blocking or filtering out the debris, known as emboli, may be effective in improving results.

New devices exist that may prevent the passage of this debris into the kidney and may lead to better patient outcomes, said Edwards. We are currently conducting a clinical trial to explore this question.

As many as 3.5 million Americans over age 65 years have blocked kidney arteries that can lead to severe high blood pressure and kidney failure. These patients have a greater risk of having heart attacks or strokes, becoming dependent on dialysis, or dying.

In some cases, blockages are cleared by inflating a balloon-like device inside the vessel (angioplasty) and inserting a stent to keep the vessel open. The procedure is performed on about 40,000 to 80,000 people a year. Bypass surgery on the arteries is also an option, but few centers offer the complex surgery.

Based on laboratory studies, researchers have suspected that ang
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