Renal Angioplasty in Hypertension: Technique, Radiological and Clinical Results, and Complications in 134 Dilatations

Complications in Percutaneous Transluminal Dilatation of Renal Arteries

“…Reoperations are not uncommon (30%), but are not declared as complications. In multicen ter studies the death rate is around 6% [16,17], while it is 2% in the very best single-center series [18,19], To give a gross description of the patients treated, the relation of patients with AS to the patients with FMD is indicated in accordance with the surgical literature [16][17][18][19], although these diagnoses are sometimes debatable and such infor mation is not always given in the radiological literature [7][8][9][10], In contrast to the success rate [1][2][3], the complica tion rate is apparently not dependent on the FM D/SA ratio. By and large, our review shows a rate between 2 and 4% of major complications directly related to PTA.…”

“…By studying table I, the results of the papers by Boomsma [8] and Puijlaert et al [9] may merit special attention because both are based, at least in part, on the same patients. While Boomsma observed a total fre quency of complications in 50% of the cases and 3 deaths, Puijlaertetal.…”

“…The complications include the following: A first group comprises complications directly related to PTA including major hemorrhage at the punc ture site most common in either the femoral [1][2][3][4][5] or axillary region with the possibility of arm plexus injuri [5,6]. Hemorrhage from renal artery or access artery perfor ation or rupture [5,[6][7][8][9]10], occlusive or nonocclusive dissection of the renal artery [1 -3,11] or access artery [4,8], acute or late renal artery thrombosis are also but less frequently reported [2,7,9,11,12], Renal artery spasm or embolism leading to segmental renal infarction are not uncommon and seem to be associated with the use of guide wires [3,4,8,9,[13][14][15], while peripheral artery embolism and balloon rupture complications are rare [3,6,8,9,13]. A second group includes complications indi rectly related to PTA such as transient or irreversible renal insufficiency [2,3,5,6], pressure-drop-related cere bral [11,12] or myocardial ischemia [2,3], contrast media hypersensitivity reactions [3], infections …”