Objectives: Renal artery stenting is a routinely performed procedure; however intervention for chronic total occlusion (CTO) is hardly reported. We attempted to open 11 totally occluded renal arteries in 10 patients.
Material and Method: The selection criteria included 1. Serum creatinine <3.0 mg% 2. Normal kidney size on ultrasound 3. Presence of Cortico medullary differentiation on ultrasound.
Results: The patient population consisted of 7 males and 3 females in the age group of 26 to 69 years. Hypertension was present in all the patients and diabetes and hypercholesterolemia was present in 20% and 40% respectively. The etiology of renal CTO was atherosclerosis in 8 patients, aortoarteritis in one patient and in one patient it was equivocal. Mean serum creatinine was 2.0 mg% (range 1.2 – 2.8 mg%). The contralateral renal artery was totally occluded in one patient and had 30-60% stenosis in four patients. The procedure was successful in 8 out of 10 patients and 8 out of 11 arteries. There were no procedural complications. Better hypertension control occurred in all patients with successful opening of renal CTO. Mean fall in serum creatinine in successful patients was 0.4mg%. Renal scans were performed in 4 patients after successful procedures which showed 26 -38% contribution to glomerular filtration rate (GFR) by the treated kidney.
Conclusion: Treating renal artery CTO by percutaneous intervention was feasible in 80% patients resulting in better hypertension control and fall in serum creatinine with renal scan showing useful contribution to GFR by the treated kidney.
