Nephrol Dial Transplant (2003) 18: 1700-1703
© 2003 European Renal Association-European Dialysis and Transplant Association
Editorial Comment
Do protection devices have a role in renal angioplasty and stent placement?
Guys and St Thomas Trust, London, UK
Correspondence and offprint requests to: John E. Scoble, Guys Hospital, St Thomas Street, London SE1 9RT, UK. Email: john.scoble@gstt.sthames.nhs.uk
Keywords: renal angioplasty; renal atherosclerotic vascular disease; stent placement
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In renal atherosclerotic vascular disease there is often no firm randomized trial data to guide clinical practice. Nephrologists often have to interpret trial data from other vascular territories. Vascular protection devices are now an issue in the carotid and cardiac territories. Should they have a role in renal atherosclerotic disease?
There is considerable literature on renal atheroembolic disease. The early paper of Thurlbeck and Castleman [1] showed that in post-mortem renal histology analysis after aortic aneurysm repair followed by death there was an incidence of renal atheroembolic disease of >70%. It also showed that there was a >20% incidence of atheroembolic disease in individuals with no intervention but severe aortic atherosclerotic disease. Flory [2] showed that this condition is related to cholesterol crystal embolization to the renal vascular bed and suggested that the vessels occluded were between 55 and 900 µm in diameter. There
Embolization at angioplasty?
Embolization and type of procedure
Stent protection
Conclusion and perspective
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