Keith Wheatley, MD, professor of medical statistics at the Birmingham Clinical Trials Unit at the University of Birmingham in the U.K., and principal investigator for ASTRAL, observed: “We were disappointed because you always start off a trial hoping that the treatment you are investigating will turn out to be better and therefore improve patient outcome.”
“Renal stenting is a commonly performed procedure in the U.K and the results from ASTRAL will now mean that there will be fewer performed,” Dr. Wheatley said. “We do need to have longer term follow-up. So, it is not impossible that there might be a longer- term benefit that might start to emerge, but at the moment there is no real sign of that. Cardiovascular events are common in this population, so we are following up long-term to look at heart attacks, strokes, and other vascular events, as well as blood pressure control and long-term survival.”
A previous study conducted by Dr. Kalra and colleagues on the Medicare population has shown that approximately 16% of all patients in the United States who are diagnosed with atherosclerotic renovascular disease are subjected to renal stenting, which translates to at least 20,000 patients a year.