Percutaneous transluminal dilatation or surgery in the management of renal vascular hypertension?
1. Twelve patients with renal artery stenosis due to fibromuscular disease (FMD) were treated with percutaneous transluminal dilation (PTD) and their results (first year) compared with those for 26 patients treated with attempted renal artery bypass. The cumulative probability of cure at 1 year was 0.67 for PTD and 0.36 for surgery (P = N.S.) in patients with FMD. The cumulative probability of being improved or cured was 0.92 for PTD and 0.88 for surgery. 2. Eighteen patients with renal artery stenosis due to atherosclerosis were treated with PTD and their results compared with those of 28 patients treated by surgery. The cumulative probability of cure at 1 year was 0.11 for PTD and 0.17 for surgery (P = N.S.). The cumulative probability for cure or improvement at 1 year was 0.30 for PTD and 0.88 for surgery (P less than 0.001). 3. We conclude that PTD may be a satisfactory alternative to surgery in fibromuscular disease, but is inferior to surgery in atherosclerotic disease causing renal artery stenosis. 4. A randomized clinical trial is needed to define the role of PTD and surgery in renal artery stenosis.
D000328:Adult; D001161:Arteriosclerosis / Q000601:surgery; D004106:Dilatation / Q000379:methods; D005352:Fibromuscular Dysplasia / Q000601:surgery; D006801:Humans; D006977:Hypertension, Renal / Q000601:surgery*; D006978:Hypertension, Renovascular / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000601:surgery*