Ultra-Low-Dose Contrast Using Transluminal Renal Angioplasty: The ULTRA Study

Author:

Kawano Megumi1ORCID,Suzuki Kenji1,Fujimura Naoki2ORCID,Endo Ayaka1,Kato Ai3,Fujii Kentaro3,Komatsu Motoaki3,Takahashi Toshiyuki1,Ryuzaki Munekazu3,Harada Hirohisa2

Affiliation:

1. Department of Cardiology, Tokyo Saiseikai Central Hospital, Minato-ku, Japan

2. Department of Vascular Surgery, Tokyo Saiseikai Central Hospital, Minato-ku, Japan

3. Department of Nephrology, Tokyo Saiseikai Central Hospital, Minato-ku, Japan

Abstract

Background Although severe atherosclerotic renal artery stenosis (ARAS) is a predictor of future cardiovascular events, large trials have not shown the benefits of percutaneous transluminal renal angioplasty (PTRA). This study aimed to validate the safety and efficacy of PTRA using low-concentration digital subtraction angiography (LC-DSA) in patients with severe ARAS and advanced chronic kidney disease (CKD). Materials and Methods This prospective study was conducted between August 2018 and October 2021. Eighteen patients with 20 lesions, CKD stage 3b or worse, and significant renal artery stenosis were included and underwent PTRA using ultra-low-dose contrast medium. The primary endpoint was a change in renal function based on serum creatinine (sCr) level. Results The mean sCr level significantly improved from 3.34 ± 1.8 mg/dL pre-PTRA to 2.48 ± 1.19 mg/dL at 1 month post-PTRA ( P = .02). The mean amount of contrast used was 8.3 ± 3.9 mL per vessel. More severe stenosis and rapid deterioration of renal function before treatment were associated with improved kidney function. No cardiovascular or renal complications such as stroke or contrast-induced nephropathy were observed during the 30-day period. Conclusions PTRA using an ultra-low-dose contrast medium is safe and provides acceptable results.

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,General Medicine,Surgery

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