Safety and efficacy results of percutaneous renal stent implantation in patients with acute coronary syndrome with ectatic and aneurysmatic coronary arteries

ABSTRACT

Background

For the treatment of stenotic lesions developing in dilated coronary arteries, it is difficult to find an appropriately sized coronary stent given that the vessel diameter is too large. This poses a greater problem, especially in patients who require urgent intervention, such as acute coronary syndrome.

Objective

We aimed to evaluate the efficacy and safety of renal stents implanted in ectatic/aneurysmatic coronary arteries in such patients.

Methods

In total, 18 patients (renal stent group) who underwent renal stent implantation in ectatic/aneurysmatic coronary arteries requiring percutaneous coronary intervention (PCI) and 45 patients who underwent large-sized bare-metal coronary stent (BMCS) implantation (BMCS group) at our center were included in the study. The primary endpoints were MACE (myocardial infarction and cardiovascular mortality), and the secondary endpoints were restenosis and all-cause mortality.

Results

In the study patients with a mean follow-up of 25.3 ± 14.6 months (1–48 months), the control coronary angiography duration was 24.6 ± 14.8 months for the renal stent group and 22.8 ± 15.7 months for the BMCS group (p = 0.06). The MACE was observed in 2 (11.1%) patients in the renal stent group and 4 (8.9%) patients in the BMCS group (HR: 1.39 (0.24–7.82), p = 0.70). The secondary composite outcome was identified in 4 (22.2%) patients in the renal stent group and 6 (13.7%) patients in the BMCS group (HR: 1.93 (0.53–6.91), p = 0.31). No significant differences in primary and secondary outcomes were noted between the groups.

Conclusion

Renal stents used during PCI in patients with acute coronary syndrome with ectatic/aneurysmatic coronary arteries have similar efficacy, and mid-term follow-up results those noted for BMCS. These findings support that renal stents can be used in ectatic and aneurysmatic coronary arteries when necessary.

Clinical Trial Registration

This study has been registered on ClinicalTrials.gov (NCT05410678).

KEYWORDS:

• Coronary
• renal
• stent
• safety
• efficacy

Acknowledgments

This study was previously presented as an oral presentation at the 3rd Uludag Cardiology Summit (16^th-19^th March 2023, Uludag, Bursa). The authors thank Ömer Faruk Kahraman, B. Mete Ülker, Selçuk Demiray, Samet Arslan, Mehmet Aşçı, M. Nusret Akın, Kübra Severgün, Elif Güçlü, and Mehmet Can Çılgın for their contributions to the study.

Author contributions

Conceptualization: Sencer Çamcı, Hasan Arı; Methodology: Hasan Arı, Sencer Çamcı and Ayşe Sünbül; Supervision: Hasan Arı, Mehmet Melek and Tahsin Bozat; Materials: Sencer Çamcı, Hasan Arı and Ayşe Sünbül; Data collection and/or processing: Ayşe Sünbül, Sencer Çamcı, Hasan Arı and Selma Arı; Analysis and/or interpretation: Hasan Arı, Tahsin Bozat and Mehmet Melek; Literature search: Sencer Çamcı, Selma Arı and Mehmet Melek; Writing: Sencer Çamcı, Hasan Arı, Ayşe Sünbül, Selma Arı and Mehmet Melek; Critical review: Sencer Çamcı and Hasan Arı. All authors have read and agreed to the published version of the manuscript.

Ethics statement

The study was conducted in accordance with the principles of the Declaration of Helsinki and approved by the Clinical Research Ethics Committee of Bursa Postgraduate Hospital (Approval No: 2011-KAEK-25). Informed consent was obtained from all subjects involved in the study.

Additional information

Funding

This paper was not funded.