[Prognostic factors in percutaneous transluminal dilatation of the renal arteries in renovascular hypertension].
In 59 percutaneous transluminal dilatations (PTD) the coaxial double catheter system was chiefly used, and only in one case was the axillary approach necessary. Clinically relevant complications were 1 dissection of the dilated renal artery (re-dilated successfully) and 2 hemorrhages at the femoral puncture site (1 surgical repair). In 32 patients (follow-up 2-52 months, mean 20 months) blood pressure was lowered from 187/108 to 150/91 mm Hg despite reduced antihypertensive therapy (p less than 0.001). Out of 15 patients with atherosclerotic stenoses blood pressure was normalized by PTD in 2 cases (unilateral) and improved in another 8 cases. Out of 11 patients with fibromuscular dysplasia blood pressure was normalized in 7 cases (all unilateral), improved in 3 and unchanged in 1 (bilateral). Among 6 patients with miscellaneous disease (vasculitis, renal insufficiency) only 2 were improved. Thus, PTD of renal arteries is a useful alternative in the management of renovascular hypertension, mainly in patients with fibromuscular dysplasia, unilateral stenosis and elevated renal vein renin ratio. Long-term results are comparable to the surgical results. However, since no surgical dissection is necessary, morbidity is low and long and costly hospital stays can be avoided. The procedure can be repeated in relapsing cases. For rare complications a vascular surgery team should be available.
D000328:Adult; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001161:Arteriosclerosis / Q000628:therapy; D005352:Fibromuscular Dysplasia / Q000628:therapy; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D006977:Hypertension, Renal / Q000628:therapy*; D006978:Hypertension, Renovascular / Q000628:therapy*; D008875:Middle Aged; D011379:Prognosis; D012077:Renal Artery / Q000293:injuries; D012078:Renal Artery Obstruction / Q000628:therapy; D012421:Rupture
Prognostische Faktoren der perkutanen transluminalen Dilatation von Nierenarterien bei renovaskulärer Hypertonie.