Single-Dose Captopril Scintigraphy in the Diagnosis of Renovascular Hypertension

Sfakianakis, George N.; Bourgoignie, Jacques J.; Jaffe, David; Kyriakides, George; Perez-Stable, Eliseo; Duncan, Robert C.

doi:10.1016/s0022-5347(17)40669-0

Cited by 20 publications

(45 citation statements)

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“…The accuracy of captopril renography in identifying patients with renovascular disease has been variable, with reported sensitivities of approximately 85% (range 45% to 94%) and specificities of approximately 93% (range 81% to 100%) (674)(675)(676)(677)(678)(679)(680)(681)(682)(683)(684)(685).…”

Section: Class I 1 Duplex Ultrasonography Is Recommended As a Screenmentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,969

1,111

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Section: Class I 1 Duplex Ultrasonography Is Recommended As a Screenmentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,969

1,111

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“…Among these 4, two kidneys had stenosis of accessory RA with normal main RA and one kidney was poorly functioning. 11 Captopril Tc99m-DTPA Sensitivity-80%, Specificity-100% Nally JV et al (1988) 12 Captopril Tc99m-DTPA Sensitivity-100%, Specificity-100% Safakianakis GN (1989) 13 Captopril-131-OIH Sensitivity-100%, Specificity-100% Svetkey LP et al (1989) 14 Captopril Tc99m-DTPA Captopril-131-OIH Sensitivity-91%, Specificity-50% Sensitivity-80%, Specificity-42% Charles C et al (1990) 15 Captopril Tc99m-DTPA Without Captoril Sensitivity-91%, Specificity-93% Sensitivity-43-68% Kakizaki H et al (1992) 16 Captopril Tc99m-DTPA Sensitivity-86%, Specificity-100% Man SJ etv al (1992) 17 Captopril Tc99m-DTPA Sensitivity-93%, Specificity-95% 18 …”

Section: Resultsmentioning

confidence: 99%

“…23 Sfakianakis NG et al (1987) compared 131 I-iodohippurate (OIH) and Tc99m-DTPA Scintigraphy in same patient and showed that scintigraphy with OIH scintigraphy with OIH appears to be more sensitive and specific than DTPA and concluded that OIH scintigraphy with captopril may provide a rapid and sensitive screening test for RVH. 24 Fommei E at al (1987) reported positive captopril induced changes in Tc99m-DTPA scintigraphy which predicted patients who can be cured by revascularization or percutaneous transfemoral renal angioplasty (PTRA). 25 Mann S J et al (1991) compared usefulness of 131 I-OIH scintigraphy to be more accurate than Tc99m-DTPA.…”

Section: Discussionmentioning

confidence: 99%

“…27 As far as ACE inhibitor scintigraphy is concerned there are many studies available which are shown in Table 1, but yet there is no consensus on scintigraphy protocol including radiopharmaceutical, sequence of studies, ACE inhibitors, their dose and specific criteria. [8][9][10][11][12][13][14][15][16][17][18][19][20] Nally JV et al achieved the sensitivity and specificity of 100% and their criteria for positive test were decrease in maximum activity, delayed uptake, widening of peak activity and slowing the excretory phase. 12 But on contrary , Kumar r et al and Orellana P et al showed lower sensitivity of 44.4% and 60.9% respectively.…”

Section: Discussionmentioning

confidence: 99%

“…1 A large list of studies is available in the literature regarding the role of renal scintigraphy with Tc99m-DTPA and with other radioactive pharmaceutical agents, with or without captopril in screening and diagnosing patients with RAS with variable and concontrdictory results. [8][9][10][11][12][13][14][15][16][17][18][19][20] The exact role and accuracy of this investigation in screening of the patients with RAS is not established. With rapid advance in technique and radiotracer in nuclear medicine, there is need to find a suitable screening method for diagnosis of RAS.…”

Section: Introductionmentioning

confidence: 99%

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Captopril Renal Scintigraphy in Screening and Diagnosis of Renal Artery Stenosis - A Prospective Study

et al. 2013

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The present study was carried out to assess the role of Tc99m-DTPA captopril renal scintigraphy in screening and diagnosing of patients with renal artery stenosis. Materials and Methods: A total of 26 hypertensive patients with a clinical suspicion of RAS underwent baseline and captopril scintigraphy using 259-370 MBq (7-10mCi) of Tc99m-DTPA. The captopril scintigraphy was done after oral dose of 50mg of captopril with in three baseline study. DSA was done in all patients irrespective of scintigraphy results due to high clinical suspicion of RAS. Results: Of 26 patients, 18 had renal artery stenosis (10 unilateral, 8 bilateral), making a total of 26 involved RA on DSA. Of these 26 involved RA, 16 were stenosis> 60%, 2 were stenosed< 60% while 8 were completely occluded. Of the sixteen RA with stenosis > 60%, only 12 were detected by captopril scintigraphy (Sensitivity-75%). Eight kidneys with complete occlusion, 6 were non-functioning and 2 were poorly functioning (<20%) on scintigraphy. Among 27 normal RA, (25 normal and two <60% stenosis) only 19 were negative on scintigraphy (specificity-70%). Two kidneys with less than 60% stenosis were positive on scintigraphy. The overall accuracy of captopril DTPA scintiography was found to be 72.1% with PPV and NVP of 66.7% and 82.6% respectively. Two patients with accessory RA were not picked up on captopril scintigraphy. Conclusion: Tc99m-DTPA captopril scintigraphy has average sensitivity and specificity. The effectiveness of captopril scintigraphy in diagnosis of completely occuluded RA, accessory RAS and RAS in poorly functioning kidney is poor, therefore this test can not be considered as screening test for RVH.

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Captopril radionuclide test in renovascular hypertension: a European multicentre study

et al. 1993

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The diagnostic work-up of renovascular hypertension is still controversial. The efficacy of renal scintigraphy with technetium-99m diethylene triamine pentaacetate (DTPA) before and after captopril (scintigraphic captopril test) was evaluated in a multicentre study. All 380 hypertensive patients in the study underwent renal arteriography; 125 had renal arterial stenosis > or = 70%, and 54 had a technically successful intervention to correct the stenosis. The post-captopril study had a sensitivity of 93% and a specificity of 100% for predicting blood pressure response to intervention, if renal function was normal and a combination of quantitative parameters was applied (individual kidney uptake index < 40%, time to peak activity < 2 min or > 10 min). In the entire population renal artery stenosis > or = 70% was detected with a sensitivity of 83% and a specificity of 93% if renal function was normal. In patients with abnormal renal function the performance of the test was worse, owing to a lower specificity which could be increased by using only time parameters. The performance of the test was optimal when the post-captopril findings were examined; no improvement was achieved by evaluation of the changes induced by captopril from the baseline. The test can thus be simplified by performing only a post-captopril study for routine use: a negative test would exclude a curable form of renovascular hypertension in > 80% and a positive test would predict it in > 90% of the patients selected for suspicion of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

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Single-Dose Captopril Scintigraphy in the Diagnosis of Renovascular Hypertension

Cited by 20 publications

References 0 publications

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Captopril Renal Scintigraphy in Screening and Diagnosis of Renal Artery Stenosis - A Prospective Study

Captopril radionuclide test in renovascular hypertension: a European multicentre study

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