Long term follow-up of percutaneous transluminal renal angioplasty with special reference to aorto-arteritis.
Percutaneous transluminal renal angioplasty (PTRA) was attempted in 96 patients of renovascular hypertension (RVHT) admitted during the period 1986 to 1992. The patients' age ranged from 14-70 (mean: 38.7 +/- 18.8) years. There were 42 (43.8%) males and 54 (56.2%) females. The cause of renal artery stenosis (RAS) was aorto-arteritis in 44 (45.8%), atherosclerosis in 28 (29.2%) and fibromuscular dysplasia in 24 (25%). Bilateral RAS was found in 16 (16.7%). PTRA was angiographically successful in 92 (95.8%) patients. The mean pressure gradient decreased from 82.6 +/- 8.2 to 11.2 +/- 3.6 mm Hg in aorto-arteritis, 75.2 +/- 13.2 to 9.6 +/- 6.4 mm Hg in atherosclerosis and from 86.4 +/- 10.6 to 13.2 +/- 8.2 mm Hg in fibromuscular dysplasia respectively. The patients were followed up for 43.2 +/- 24.1 (range: 6-77) months. Remission or satisfactory lowering of blood pressure was achieved in 80 (86.9%) patients. Clinical success rate (remission or satisfactory lowering of BP) at the end of follow-up period was 75.3 percent. Randomly selected repeat angiography was done in 45 out of 92 (49.1%) patients at the end of 24 months of follow-up. Restenosis was detected in 12 (26.7%) patients and was commonest in the atherosclerotic group (42.8%), followed by fibromuscular dysplasia (14.3%) and least common in aorto-arteritis (11.8%). Repeat angioplasty was done successfully in 10 (83.3%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Chatterjee
S S
SS
Department of Cardiology, Institute of Postgraduate Medical Education & Research, Calcutta.
Pahari
D K
DK
Sharma
R K
RK
Halder
B
B
Roy
S
S
Ghosh
S
S
Biswas
P
P
Banerjee
A
A
Khan
A
A
Mukherjee
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001025:Aortitis / Q000150:complications*; D001161:Arteriosclerosis / Q000150:complications; D005260:Female; D005352:Fibromuscular Dysplasia / Q000150:complications / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000209:etiology* / Q000628:therapy*