Percutaneous transluminal renal angioplasty in the management of hypertension and renal failure in patients with renal artery stenosis.
Percutaneous transluminal renal angioplasty (PTRA) is an accepted method of treatment of hypertension resulting from renal artery stenosis. There is less information on the role of PTRA in patients with renal artery disease and renal impairment. We report on 30 patients who underwent PTRA for renal artery stenosis (13 had uncontrolled hypertension and normal renal function and 17 had hypertension and renal insufficiency; 26 patients had atheromatous disease, fibromuscular dysplasia was diagnosed in 2 and 2 patients had renal artery stenosis to a transplant kidney). These 30 patients had 43 PTRA procedures, with the 'initial technical success' rate of 81% and the 'overall success' rate of 79% after ten months. Results of renal PTRA on BP showed the initial benefit in 88% of patients: 71% 'cured' and 17% 'improved'. After ten months only 38% of patients could still be considered 'cured' and 33% 'improved'. Renal function 'improved' in 68% of patients who presented with renal insufficiency. An improvement of BP control or renal function was less likely in patients with bilateral severe atheromatous disease. PTRA is an effective treatment for renal artery stenosis. Satisfactory improvement of BP control and improvement or prevention of further deterioration of renal function may be achieved in a high proportion of patients.
Tykarski
A
A
University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.
Edwards
R
R
Dominiczak
A F
AF
Reid
J L
JL
D000328:Adult; D000368:Aged; D017130:Angioplasty; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000628:therapy*; D012079:Renal Circulation; D016896:Treatment Outcome