Transradial Approach for Renal Artery Angioplasty and Stenting in Chinese Patients: Single Center Experience

Background: Conventional renal artery angioplasty is performed through femoral artery access. Femoral artery access requires several hours of bed rest to ensure hemostasis, and combined vascular complications are frequently encountered. It has been proven that the transradial approach for coronary artery intervention is technically safe and feasible. In this study, we used this alternative approach for percutaneous transluminal renal angioplasty (PTRA) and stenting (PTRS). Methods: Twenty patients with 21 renal artery stenotic lesions were treated via the left radial artery approach. The intervention was carried out using a 6 French (Fr) system for PTRA and PTRS. Result: The immediate procedural success was 100% (three PTRAs and eighteen PTRSs). Direct stenting was performed in 8/21 stenoses; predilatation was necessary in 10/21. The only major complication was one renal artery perforation with perirenal hematoma requiring transfusion. There was no procedure-related death or cerebrovascular event. One patient with severe coronary artery disease suffered from sudden death 1 month after the intervention. Angiographic follow-up was obtained in 7 patients with 8 renal arteries treated (38.1%) after a mean 11.0 7.8 months. There was one angiographic instent restenosis (12.5%), which required a repeat balloon angioplasty. Clinical follow-up at a mean of 14.3 14.5 months revealed that renal function had improved in 4 (21.0%), had remained stable in 9 (47.4%), and had worsened in 6 (31.6%). Hypertension was found to have reversed in 1 (5.3%), to have improved in 5 (26.3%), and to have remained unchanged in 13 (68.4%). Conclusions: Transradial renal artery intervention is technically feasible and safe. An additional advantage is the ease with which hemostasis is achieved and the elimination of bleeding complications that allow immediate ambulation after the procedure. Therefore, transradial approach can be considered as an alternative to traditional transfemoral approach for renal artery intervention.