Thomas A. Simone, MD, Benjamin S. Brooke, MD, PhD, Philip P

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Clinical effectiveness of secondary interventions for restenosis after renal artery stenting Thomas A. Simone, MD, Benjamin S. Brooke, MD, PhD, Philip P. Goodney, MD, MS, Daniel B. Walsh, MD, David H. Stone, MD, Richard J. Powell, MD, Jack L. Cronenwett, MD, Brian W. Nolan, MD, MS Journal of Vascular Surgery Volume 58, Issue 3, Pages 687-694 (September 2013) DOI: 10.1016/j.jvs.2013.03.009 Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 1 Interventions in the patient cohorts. A total of 216 primary interventions were identified in 180 patients. Seven patients undergoing intervention for fibromuscular dysplasia were excluded. Within this cohort, we identified 57 patients who subsequently underwent 65 secondary interventions for restenosis associated with worsening renovascular hypertension or renal dysfunction, or both. Outcomes after these secondary interventions were compared with outcomes after primary interventions, with each primary and secondary renal artery intervention comprising the unit of analysis for comparison. PSV, Peak systolic velocity; RAR, renal artery ratio. Journal of Vascular Surgery 2013 58, 687-694DOI: (10.1016/j.jvs.2013.03.009) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 2 Blood pressure and renal function improvement are illustrated after primary vs secondary interventions. Patients undergoing secondary interventions had improvement in blood pressure at last follow-up that was comparable with patients undergoing primary interventions by American Heart Association (AHA) criteria. NS, Not significant. Journal of Vascular Surgery 2013 58, 687-694DOI: (10.1016/j.jvs.2013.03.009) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 3 Rates of freedom from restenosis according to duplex ultrasound (DUS) criteria were similar after secondary and primary interventions at 1-year (13% secondary vs 16% primary) and 3-year (50% secondary vs 59% primary) follow-up intervals. Journal of Vascular Surgery 2013 58, 687-694DOI: (10.1016/j.jvs.2013.03.009) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 4 Average peak systolic velocity (PSV) on duplex ultrasound (DUS) imaging was significantly lower at 1 month than the average PSV before primary intervention and reintervention. The average PSV between primary intervention and reintervention was not significant (NS). The range bars show the standard error. Journal of Vascular Surgery 2013 58, 687-694DOI: (10.1016/j.jvs.2013.03.009) Copyright © 2013 Society for Vascular Surgery Terms and Conditions

Fig 5 There was no difference in 3-year patient survival by Kaplan-Meier life-table analysis between patients after secondary interventions compared with patients who underwent only primary interventions. Journal of Vascular Surgery 2013 58, 687-694DOI: (10.1016/j.jvs.2013.03.009) Copyright © 2013 Society for Vascular Surgery Terms and Conditions