[Percutaneous transluminal renal angioplasty: indication for renovascular hypertension associated with renal atrophy].
The results of clinical studies indicate that percutaneous transluminal renal angioplasty (PTRA) is an effective means for treating renovascular hypertension resulting from renal artery stenosis. However, the indications for the patients with renal failure or renal atrophy are not established on a firm ground. We attempted PTRAs of ten kidneys in nine patients with hypertension associated with renal atrophy. They were followed for an average of 8 months by the methods including blood pressure, angiography or DSA, blood chemistry, and RI-renogram. We also evaluated enlargement of the renal size on an angiogram or on a plain film at DSA. Angiographic follow-up showed persistent relief of the stenosis in all cases. After PTRA, blood pressure reduced to normal or improved in two thirds of the patients for the follow-up period. In the study of three patients with excellent results for blood pressure, two patients showed the renal length to be increased by 1.0 cm or more, and one patient by 0.5 cm. In the same group, RI-renogram also showed good response. These data indicate that PTRA could improve total perfusion on the affected kidneys. On the other hand, in three patients with no change in blood pressure, there was poor response in both the renal size and the data of RI-renograms. We suggest that the irreversible changes might have occurred in these kidneys. It was difficult to predict cure group from no change group before PTRA.
Korogi
Y
Y
Takahashi
M
M
Bussaka
H
H
Yamashita
Y
Y
Takaki
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001284:Atrophy / Q000150:complications; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000150:complications / Q000628:therapy*; D007668:Kidney / Q000473:pathology*; D008297:Male; D008875:Middle Aged