Prediction of response to revascularization in patients with renal artery stenosis by Tc-99m-ethylenedicysteine captopril scintigraphy

Abstract

The aim of the present study was to assess the predictive value of captopril scintigraphy with the new renal agent 99mTc-ethylenedicysteine (99mTc-EC) for post-interventional improvement in blood pressure. Twelve patients who had persistently high blood pressure with previous demonstration of various degrees of renal artery lesion on angiography were included into the study. Baseline and captopril scintigraphies were performed on the same day at 4 hour intervals after the injection of 74 and 296 MBq of 99mTc-EC, respectively. All patients had percutaneous transluminal angioplasty (PTA), and improvement in blood pressure was evaluated 3-6 months after the intervention. 99mTc-EC captopril scintigraphy successfully predicted a positive or negative outcome in 11 of 12 patients. In one patient with captopril induced renal function deterioration, scintigraphy failed to predict post-interventional response. Our preliminary findings showed that 99mTc-EC captopril scintigraphy can be used to determine patients who will benefit from revascularization.

Arteriosklerotische Nierenarterienstenose

“…In der Hand des Erfahrenen weisen alle genannten Screeningverfahren akzeptable Sensitivitäten und Spezifitäten auf [64]. Screeninguntersuchungen durch Messung der Captopril-induzierten Plasmareninaktivität erfordern häufig die Umsetzung der antihypertensiven Medikation, ACE-Hemmer, AT1-Rezeptor-Antagonisten und Diuretika müssen über mehrere Wochen abgesetzt sein [18,34,44,79]. Sie sind deshalb und wegen ihrer nicht immer über-zeugenden Sensitivität und Spezifität zur Erfassung von Nierenarterienstenosen in der Praxis nur in Einzelfällen anwendbar.…”