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Angioplasty may Damage Kidneys

ioplasty releases particles into the bloodstream presumably made up of bits of clot and fatty plaque material from the blockage. The goal of the current study was to count the particles and determine if they are associated with impaired kidney function after the procedure.

In 28 angioplasty cases, researchers used a protection device to temporarily block the vessel at the site of the angioplasty and stenting. After the procedure, and while the protection system was still in place, researchers took a small sample of blood trapped by the protection device. The artery was then aspirated and flushed out to remove any remaining particles.

Laboratory analyses found a mean of 2,000 particles captured per blood sample many of them large enough to block the small vessels in the kidney.

The more particles collected from a patient, the worse their kidney function, said Edwards. Patients with higher levels of particles in their blood were more likely to have decreased kidney function after the procedure. Poor kidney function after kidney artery stenting has been previously demonstrated by our group to be associated with increased risk of heart attack, stroke or death in the future.

The results raise an important question: since the protection device was in place for the procedures, and it is designed to remove particles from the vessel, why did patients who had high particle counts before the artery was flushed also have worse kidney function afterwards"

The researchers theorize that some blockages are more prone to releasing particles than others and that just putting the protection device in place releases particles that reach the kidneys.

The study raises many questions, including how well the protection device works and can we predict which plaques are more prone to release debris, said Edwards. We are currently conducting a clinical trial to try and answer these questions.

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