Endovaskuläre Therapie der Nierenarterienstenose: Technische Ergebnisse mit dem Palmaz®-CorinthianTM-Stent

Objective: To evaluate the technical performance and delivery characteristics of the Palmaz-Corinthian stent for endovascular therapy of atherosclerotic renovascular disease. Methods: 61 patients underwent implantation of 76 Palmaz-Corinthian (PC) stents in 72 arteries. 50 original PC and 26 PC stents with the modified IQ- design were employed. The indications comprised primary stenting of ostial (n=49) or truncal (n=1) stenosis or occlusion (n=3), and selective stenting following complicated (dissection, n=4) or unsuccessful (n=8) angioplasty. The remaining stents were placed in patients with recurrent stenosis (n=5) or acute aortic dissection (n=2) involving the renal artery. Mean severity and length of stenosis were 81,3% and 9.8 mm, respectively. 39 lesions were rated eccentric or calcified. Data on technical success, complication rate, delivery characteristics and ease of placement compared to standard renal stents were retrieved from a prospective multi-center registry. Results: Stent delivery was successful in all patients, major complications were not reported. Stent placement was suboptimal in 7 of 72 cases: 4 stents were located too distally in the renal artery, necessitating proximal coaxial overstenting in 2 cases. The distal part of the stenosis was incompletely covered and the orifice of a segmental branch inappropriately overstented in one case each. One stent was dislodged from the balloon, resulting in stent protrusion in the aortic lumen. Significnt residual stenosis after stenting was not observed. Overall stent deliverability, trackability and potential repositioning inside the stenosis were rated positive, radio-opacity was rated superior for the IQ design, Conclusion: Technical performance and delivery characteristics of the Palmaz-Corinthian stent have been significantly improved compared to the Palmaz design, allowing mostly correct placement in renal artery stenoses with a low complication rate.