[Renal artery dilatation in renovascular hypertension. Acute and long-term outcome in a large patient sample].
BACKGROUND
Renal angioplasty is an established therapy for treatment of renovascular hypertension. This study was performed to evaluate short- and long-term outcome of this procedure up until 3 years afterwards.


METHODS
Altogether, 111 renal artery stenosis in 92 patients were dilated. Among these were 31 fibromuscular and 70 arteriosclerotic lesions, 4 transplant artery stenosis and 6 occlusions.


RESULTS
The primary success rate for dilatation was approximately 90%. Serious complications occurred in 5 of the patients including 2 fatal myocardial infarctions about 2 weeks after the procedure. Restenosis (altogether 25%) almost exclusively occurred during the first few months after angioplasty (more often in arteriosclerotic lesions than in fibromuscular disease). Successful dilatation resulted in better blood pressure control. In several patients with preexisting chronic renal failure improvement of renal function was observed; in this group, however, restenosis occurred in about 1 third of the patients.


CONCLUSIONS
Renal angioplasty is a suitable method for therapy of renovascular hypertension; in patients with preexisting renal failure improvement of renal function may ensue. The decision to treat with angioplasty must be weighted carefully against other established and also newer methods (surgery vs. antihypertensive medication vs. stent implantation) and should be reserved for specialized centers.
Lenz
T
T
Medizinische Klinik IV (Kardiologie-Nephrologie), Klinikum der Johann-Wolfgang-Goethe-Universitt, Frankfurt a.M.
Bussmann
W D
WD
Schmidt
E
E
Grützmacher
P
P
D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon; D001794:Blood Pressure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
Nierenarteriendilatation bei renovaskulärer Hypertonie. Akut- und Langzeitergebnisse eines grossen Patientenkollektivs.