Follow up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation.

Abstract

Between April 1978 and April 1981, 70 patients with hypertension and renal artery stenosis were treated by percutaneous transluminal arterial dilatation. Selection of the patients was based solely on arteriographic criteria. Arteriography after dilatation showed considerable widening of the stenosed area in all patients. In 65 patients the effect of treatment on the blood pressure was assessed during follow up periods of one to four years. In 14 of these patients the hypertension was cured, in 29 it was improved, and in 22 there was no change. Patients with fibromuscular lesions benefited distinctly more than did those with atheromatous stenosis, only one of the 21 patients with fibromuscular lesions showing no change as compared with 21 of the 44 patients with atheromatous lesions. The only serious complication encountered was microcholesterol emboli, which developed in two patients with severe atheromatous lesions of the aorta. In the atheromatous group age and overall renal function had no influence on the blood pressure response. In the subgroup of patients with a unilateral lesion the renal vein renin ratios and asymmetrical

Surgery, Transluminal Dilatation and Medical Therapy in the Management of Renovascular Hypertension

“…Undoubtedly, the simplicity and effectiveness of PTD has largely contributed to this development. The ob served high incidence of cured and improved cases in FMD corresponds well with the reports of other authors [6,8], whereas in patients with ASS the proportion of cured and improved cases was even slightly higher than in other studies [5,8].…”

“…Since then, various therapeutic approaches to reno vascular hypertension have been tried, the most impor tant being reconstructive or ablative surgery, antihyper tensive drugs including converting enzyme inhibitors and percutaneous transluminal dilatation (PTD). There are numerous studies on the results of these therapeutic procedures reporting an improved and cured incidence of renovascular hypertension in 60-95% of surgically treated patients [2][3][4] and in 35-90% in dilated patients [5][6][7][8]. Medical therapy with conventional antihyperten sive drugs seems to be successful in controlling hyperten sion in about 50% of the cases [9], whereas under the converting enzyme inhibitor, captopril, sufficient blood pressure control was observed in as many as 80% of the cases [10,11], Up to now, direct comparisons between the described therapeutic regimes have been lacking.…”

Renography: Prediction of Blood Pressure after Dilatation of Renal Artery Stenosis

“…Renography during captopril treatment was performed I hafteran oraldoseof25 mg captropril given before Post-PT A OIH renogram t t n t i breakfast. The blood pressure at the time of the post-PTA renogram was compared with that before PTA and the patients classified as cured, improved or failed according to the cooperative study of Maxwell et al [1] with a slight modification [2]. In an additional group of 4 hypertensive patients without renal artery stenosis renog raphy was performed with an without captopril treatment.…”

Percutaneous transluminal renal angioplasty in nonatherosclerotic renovascular hypertension. Long-term results.

“…Our data confirm the relatively short-term results of previous studies'^9-"~1 6 and also enforce the growing perception of long-term durability of the beneficial response of hypertension to a technically successful PTRA. 17 ' 8 Indeed, the collective data indicate that angioplasty offers a strong curative potential in patients with renovascular hypertension due to fibromuscular dysplasia. Furthermore, the favorable blood pressure response of the two pediatric patients (Patients 4 and 7) in our study who underwent technically successful PTRA expands the limited experience with angioplasty in pediatric renovascular hypertension.…”