Long-term results of percutaneous transluminal angioplasty in renovascular hypertension.
OBJECTIVE
The long-term effect of percutaneous transluminal renal angioplasty (PTRA) was assessed in 50 patients with renovascular hypertension.


METHODS
Thirty-eight of the patients had atherosclerotic disease and 12 patients fibromuscular dysplasia (FMD). Dilatation with a balloon catheter were performed at 6 to 8 atm for 15 to 30 s.


RESULTS
PTRA was technically successful in 46 (92%) patients. Three of the failures underwent surgical revascularization. There was no mortality connected with PTRA. Minor complications occurred in 6 (12%) patients, and surgical intervention was required in 1. In 4 patients with restenosis, repeated PTRA was performed in 2, and surgery in the other 2 patients. Bilateral disease occurred in 12 patients, and 3 had sequential bilateral PTRA. In 9 patients with atherosclerotic ostial stenosis, PTRA was technically successful in 8 (89%). Thirty-eight patients were re-examined with a mean follow-up of 4 years. At follow-up, 5 (45%) of the patients with FMD were classified as cured, 6 (55%) as improved, and none as failed. In the 27 patients with atherosclerotic disease, 23 (85%) had long-term benefit, 3 (11%) were cured, 20 (74%) were improved, and 4 (15%) were failures. In the 8 patients with ostial atherosclerotic lesions and successful PTRA, there was a 75% long-term benefit. Two patients died during follow-up, both from myocardial infarction.


CONCLUSIONS
The result suggest that PTRA is effective in long-term management of renovascular hypertension, not only in patients with fibromuscular stenosis, but also in patients with atherosclerotic disease, even when ostial lesions are present.
von Knorring
J
J
Surgical Department IV, University Hospital, Helsinki, Finland.
Edgren
J
J
Lepäntalo
M
M
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000706:statistics & numerical data; D001161:Arteriosclerosis / Q000150:complications / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome