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Year : 2005  |  Volume : 6  |  Issue : 2  |  Page : 57-62

Bilateral renal artery stenting at Queen Alia heart institute: A review of 15 cases

King Hussein Medical Center, Queen Alia Heart Institute, Amman, Jordan

Correspondence Address:
Hatem Salaheen Abbadi
King Hussein Medical Center, Queen Alia Heart Institute, Amman
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Source of Support: None, Conflict of Interest: None

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Objective: To review the clinical pattern and associated features in 15 cases of bilateral renal artery stenosis who underwent bilateral renal artery setting at the Queen Alia Heart Institute in Jordan. Methods: Between January 2000 and December 2004, a total of 15 patients were found to have significant bilateral renal artery stenosis on routine renal angiogram during cardiac catheterization for coronary or valve diseases. These 15 patients underwent bilateral renal artery stenting. Their medical records were retrieved and clinical and laboratory data were reviewed. Unilateral renal cases were excluded. Data parameters were age, risk factors, clinical presentation, kidney function test, lipid profile, severity of coronary artery disease, left ventricular dysfunction, use of angiotensin converting enzyme inhibitors, and associated atheromatous vascular diseases. Results: The mean age was 64.4 years, two thirds were male, 80% had hypertension, and 46% had diabetes mellitus. 86% had significant coronary artery disease (13 patients), six of whom underwent coronary artery bypass surgery. Two patients had creatinine level of > 2 mg/dl, the rest were normal. As to clinical presentation, 6 presented with myocardial infarction, 6 angina, and 3 presented with pulmonary edema. Bilateral renal artery stenting was performed in all 15 patients with 93% success rate. One patient died during surgery. Conclusion: Bilateral renal artery stenosis is commonly associated with coronary artery disease. In such clinical setting, patients usually present with cardiac symptoms and minimal derangement of kidney function. Bilateral renal artery stenting can be done safely in such patients. Bilateral renal artery stenting would decrease the progression to ischemic nephropathy and improve cardiac symptoms like pulmonary edema, angina, and allow use of angiotensin converting enzyme inhibitors safely in addition to undergoing cardiac surgery with no or minimal renal complications.

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