Results of renal artery revascularization in the post-ASTRAL era with 4 years mean follow-up

Figures & data

Table 1. Baseline demographics of study cohort, 2010‒2013.

No. of patients	224
Gender (male/female)	117/107 (52%/48%)
Age, years	66.6 (41.9‒81.4)*
SBP, mmHg	168 (165‒172)*
DBP, mmHg	85 (83‒86)*
eGFR, mL/min/1,73 m^2	52.5 (49.0–56.0)*
No. of anti-hypertensive drugs	3.5 (3.4‒3.7)*
Treatment index	21.8 (20.1‒23.4)*
Anti-platelet drug
Any	119 (53%)
Double	19 (9%)
Lipid-lowering drug	132 (59%)
Smoking habits:
Current smoker	61 (27%)
Former smoker	73 (33%)
Never smoked	67 (30%)
Missing data	23 (10%)
Type of renal artery stenosis:
Atherosclerotic lesion	195 (87%)
Fibromuscular dysplasia	21 (9%)
Other stenosis	8 (4%)
Re-intervention**	18 (8%)
Indications (combinations of indications in some patients):
Hypertension, ≤2 drugs	48 (21%)
Hypertension, ≥3 drugs	177 (79%)
Declining renal function	103 (46%)
Declining renal function correlated to  ACE and ARB***	23 (10%)
Acute renal impairment	11 (5%)
Pulmonary oedema and heart failure	11 (5%)
Single kidney	26 (12%)
Preoperative co-morbidities:
Essential hypertension	159 (71%)
Ischaemic heart disease	44 (20%)
Endocarditis	3 (1%)
Atrioventricular conduction disorders	20 (9%)
Heart failure	48 (21%)
Cerebrovascular disease	11 (5%)
Peripheral arterial disease	194 (87%)
Renal impairment, acute and chronic	70 (31%)
Diabetes	43 (19%)

SBP: systolic blood pressure; DBP: diastolic blood pressure. *Mean and 95% CI.

**Patients with restenosis in previously treated artery (before 2010).

***Renal failure correlated to anti-hypertensive therapy with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB).

Figure 1. Numbers of PTRA procedures performed in the period 2006–2013. The asterisk denotes the time of publication of the ASTRAL trial.

Table 2. Procedure-related data in 224 patients subjected to PTRA.

No. of patients	224
Preoperative diagnostic imaging
n = 220
CTA	46 (21%)
MRA	74 (34%)
RADUS	39 (18%)
RADUS + CTA	15 (7%)
RADUS + MRA	24 (11%)
Angiography	18 (8%)
Other combinations of methods	4 (2%)
Trans-stenotic pressure measurements
Pre- and post-PTRA	84 (37%)
Only pre-PTRA	56 (25%)
Only post-PTRA	29 (13%)
Not done	55 (25%)
No of arteries treated	260
Bilateral treatment	34
2 arteries treated on one side	2
PTRA with stent	228
PTRA without stent	32
Stent/balloon diameter
3‒3.5 mm	6 (2%)
4 mm	12 (5%)
5 mm	57 (22%)
6 mm	132 (51%)
7 mm	50 (19%)
8 mm	2 (1%)
Technical success	256 (98%)
Complications
Major	4 (2%)
Minor	24 (11%)

CTA: computed tomography angiography; MRA: magnetic resonance angiography; PTRA: percutaneous transluminal renal angioplasty; RADUS: renal artery duplex ultrasound.

Table 3. Changes in blood pressure, renal function, and anti-hypertensive treatment over time in 224 patients subjected to PTRA.

	Systolic blood pressure	Diastolic blood pressure	eGFR	Treatment index	No. of drugs
Pre-PTRA	168	85	52.5	21.75	3.54
	(165‒172)	(83‒86)	(49.0–56.0)	(20.13‒23.37)	(3.38‒3.70)
Post-PTRA	146**	76**	54.9**	16.92**	3.05**
	(144‒149)	(75‒78)	(51.3‒58.5)	(15.59‒18.25)	(2.86‒3.24)
1-year follow-up	144**	76**	54.0	18.01**	3.32*
	(141‒147)	(74‒77)	(50.2‒57.9)	(16.51‒19.52)	(3.12‒3.53)
Last follow-up	144**	76**	51.9	17.83**	3.28*
	(141‒147)	(75‒78)	(47.6‒56.2)	(16.28‒19.39)	(3.07‒3.49)

Numbers show mean and 95% CI.

*p Value <0.05, **p Value < 0.01 compared to the mean value at the index operation, based on linear regression analyses.

Blood pressure is shown in mmHg.

eGFR: estimated glomerular filtration rate in mL/min/1.73 m².