Percutaneous transluminal renal angioplasty: initial and long-term results.
Renal artery stenosis in 201 patients with hypertension was treated with percutaneous transluminal renal angioplasty (PTRA). A total of 213 procedures were performed as treatment of 262 separate stenosis. The stenosis was caused by atherosclerosis in 134 cases and by fibromuscular dysplasia (FMD) in 52 cases; the cause was indeterminate in 27 cases. Of the 213 procedures, 172 were successful or resulted in improvement, for a technical success rate of 80.8%. The initial clinical results could be evaluated in 210 cases; cure or improvement was achieved in 80%. There were 23 cases in which neither technical nor clinical success was achieved. Data on the remaining 187 cases were the basis of this long-term follow-up study. The cumulative patency rate at 5 years was 80% in the atherosclerosis group, 89% in the FMD group, and 74% in the indeterminate group. The mortality was less than 1%. Because spasm occurred in 33 cases, causing an infarction in ten instances, antispasmodic medication seems warranted. These long-term results indicate that PTRA is the treatment of choice in patients with renovascular hypertension.
Klinge
J
J
Department of Radiodiagnosis, University Hospital Utrecht, The Netherlands.
Mali
W P
WP
Puijlaert
C B
CB
Geyskes
G G
GG
Becking
W B
WB
Feldberg
M A
MA
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D001161:Arteriosclerosis / Q000628:therapy*; D005352:Fibromuscular Dysplasia / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000628:therapy; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000628:therapy*; D013997:Time Factors; D014654:Vascular Patency