Kidney Surgery May Spur New Problems
Procedure to open renal arteries leaves large amounts of debris behind
 (HealthDay News) -- A popular procedure to open blocked kidney arteries has proven effective, but it apparently leaves behind a large amount of debris that can impair kidney function.
The procedure -- angioplasty and stenting -- is done primarily to relieve high blood pressure caused by a blockage and reduce the risk of kidney failure. It involves inserting a balloon to open the artery and then implanting a stent to keep the artery open. As many as 80,000 Americans have this procedure each year.
Although medical experts knew that the procedure created debris, a Wake Forest University Baptist Medical Center study was the first "to really demonstrate how much stuff there is and especially how much microscopic material there is," lead author Dr. Matthew Edwards, an assistant professor of surgery, told HealthDay .
For the study, Edwards and his colleagues analyzed blood samples from 28 people after they'd undergone angioplasty and stenting of kidney arteries. They found an average of 2,000 debris particles in the samples -- with some of the pieces large enough to block smaller blood vessels in the kidney.
The researchers also found the number of particles in certain people was directly associated with their subsequent kidney function. The more debris, the worse the kidney function.
Edwards said that this raises concerns about long-term health, because, "poor kidney function after kidney artery stenting has been previously demonstrated by our group to be associated with increased risk of heart attack, stroke or death in the future." The study was published in the Journal of Vascular Surgery .
Interestingly, debris was found floating freely in people's arteries even though surgeons used a protective device designed to trap the debris for removal. The device was one of several being tested. None have been approved by the U.S. Food and Drug Administration.
Certain kinds of fatty plaques might create more debris than others, Edwards said.
"The plaques that sit in these arteries are not all the same," he said. "Some might be prone to liberate more debris than others."
In the future, he suggested, it might be possible to identify the more dangerous form of debris before a person undergoes a procedure.
"There has been some work on that in the carotid artery," which supplies blood to the brain, Edwards said. "Some MRI and ultrasound studies have identified plaque that is prone to release more debris."
On the Web
To learn more about renal artery stenosis, narrowing or blockage of the artery that supplies blood to the kidneys, visit the U.S. National Library of Medicine.
SOURCES:
HealthDay News ; Matthew Edwards, M.D., assistant professor of surgery, Wake Forest University Baptist Medical Center, Winston-Salem, N.C.; June 2007, Journal of Vascular Surgery
Author:
Robert Preidt
Publication Date:
July 31, 2008
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