Intraluminal Dilatation of Renal Artery Stenosis

Geyskes, G. G.; Puylaert, C B; Oei, H. Y.; Boomsma, J.H.B.

doi:10.1042/cs057441s

Cited by 7 publications

(2 citation statements)

References 1 publication

(1 reference statement)

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“…The condition could be compared with the two-kidney, twoclip model of renovascular hypertension. During convert ing enzyme inhibition by captopril (SQ 14,225) the left renal artery stenosis was successfully dilated by an intra arterial balloon catheter (Dotter-Griintzig) [14]. By this procedure the 'two-kidney, two-clip hypertension' was changed into a 'two-kidney, one-clip hypertension'.…”

Section: Introductionmentioning

confidence: 99%

Renal Artery Dilatation in a Patient on Captopril: Changing a ‘Two-Kidney, Two-Clip Hypertension’ into a ‘Two-Kidney, One-Clip Hypertension’

Hoorntje¹,

Donker²,

Schuur

et al. 1982

Nephron

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In this paper we report on a patient with accelerated hypertension associated with a totally obstructed right renal artery and a severe constricted left one. In this ‘two-kidney, two-clip’ model of renovascular hypertension, captopril in combination with severe sodium restriction was not effective, possibly as a consequence of overloading with sodium and water due to a low renal perfusion pressure at the left side. Transluminal renal artery dilatation changed this ‘two-kidney, two-clip’ into a ‘two-kidney, one-clip’ model of renovascular hypertension, which subsequently responded well to captopril treatment. Some pathophysiological mechanisms involved are briefly discussed.

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Section: Introductionmentioning

confidence: 99%

Renal Artery Dilatation in a Patient on Captopril: Changing a ‘Two-Kidney, Two-Clip Hypertension’ into a ‘Two-Kidney, One-Clip Hypertension’

Hoorntje¹,

Donker²,

Schuur

et al. 1982

Nephron

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“…same time, a considerable number of successful dilata tions of renal artery stenosis (RAS) by means of percuta neous transluminal renal angioplasty (PTRA) has been reported in many series with an a priori wider spectrum of indications in older patients having relative contraindica-tions for surgery [3][4][5], However, some critical points remain unresolved, including identification of the best diagnostic procedure for RVH and the relative risk-bene fit balance of PTRA in atheromasic stenosis, which is often associated with less favorable outcome and more frequent complications [5]. While many authorities con sider a standard arteriography as a first choice investiga tion in most patients [5], based on a recent cost-effective ness evaluation of nuclear medicine procedures, captopril-enhanced renography was claimed to be the best diag nostic approach in RVH [6].…”

mentioning

confidence: 99%

Prospective Study on Captopril Renography in Hypertensive Patients

Roccatello

Picciotto²,

Rabbia³

et al. 1992

Am J Nephrol

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Six hundred and sixty-seven hypertensive patients were analyzed by captopril-enhanced scintigraphy. If time to reach maximal activity (T_max) was ≧ 5 min using ^99mTc-diethylenetriaminepentaacetic acid (DTPA) or ≧ 3 min with ¹²³I-oiodohippurate (OIH) and ^99mTc-mercaptoacetyltriglycine (MAG3) and washout time ≧ 15 min, a control study with nifedipine was performed. If the difference between T_max under captopril and nifedipine premedication was ≧ 5 min with ^99mTc-DTPA or ≧ 3 min with ¹²³I-OIH and ^99mTc-MAG3, the renogram was defined highly suggestive of renovascular hypertension. In the evaluation of bilateral abnormalities an additional parameter was considered, i.e. the presence of functional asymmetry of the emuntories susceptible of partial reversal in the control study under nifedipine. Based on these criteria, 58 out of 667 (8.7%) scintigrams were found to be abnormal. Thirty-five of these 58 patients and 32 of the remaining 609 scintigraphically negative cases underwent additional arteriographic examination. A renal vascular stenosis ≧ 50% was found in 33 out of 35 (94.2%) patients with positive scintigraphy and in 3 out of 32 patients with negative scintigraphy. By examining results of the 67 patients undergoing arteriography, the sensitivity of captopril-enhanced scintigraphy was estimated to be 91.6 %, with a specificity of 9 3.5 %, an accuracy of 92.5 %, and predictive values of a positive or negative result of 94.2 and 90.6%, respectively. By restricting analysis to bilateral stenosis, sensitivity was found to be 76.9%. Postexamination of 16 patients undergoing revascularization by surgery or percutaenous transluminal renal angioplasty reflected the expected results with a substantial shortening in T_max and T75 in the responsive cases.

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Transluminal Angioplasty: A Comprehensive, Chronological Bibliography 1964–1982

Dotter¹,

Ruble²

1983

Percutaneous Transluminal Angioplasty

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Intraluminal Dilatation of Renal Artery Stenosis

Cited by 7 publications

References 1 publication

Renal Artery Dilatation in a Patient on Captopril: Changing a ‘Two-Kidney, Two-Clip Hypertension’ into a ‘Two-Kidney, One-Clip Hypertension’

Renal Artery Dilatation in a Patient on Captopril: Changing a ‘Two-Kidney, Two-Clip Hypertension’ into a ‘Two-Kidney, One-Clip Hypertension’

Prospective Study on Captopril Renography in Hypertensive Patients

Transluminal Angioplasty: A Comprehensive, Chronological Bibliography 1964–1982

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