Results of renal angioplasty in nonspecific aortoarteritis (Takayasu disease).
OBJECTIVE
To evaluate the long-term results of percutaneous transluminal renal angioplasty (PTRA) in the management of renovascular hypertension caused by nonspecific aortoarteritis (Takayasu disease).


METHODS
The results of 96 stenoses in 66 patients were retrospectively studied. The indications for PTRA included hypertension uncontrolled by single-drug therapy, evidence of greater than 70% diameter stenosis in the renal artery with a peak systolic gradient of greater than 20 mm Hg, and clinically inactive disease.


RESULTS
Technical success was obtained in 91 (95%) stenoses in 62 patients. Clinical success was seen in 59 (89%) and included "cure" in 14 and "improvement" in 45 patients. The stenosis decreased from 88% +/- 6% (range, 70%-100%) to 11% +/- 12% (range, 0%-40%), systolic pressure gradient decreased from 95 mm Hg +/- 22 (range, 30-140 mm Hg) to 9 mm Hg +/- 8 (range, 0-30 mm Hg), blood pressure improved from 181 +/- 16 (range, 150-220)/115 +/- 10 (range, 90-146) to 136 +/- 25 (range, 130-210)/86 +/- 16 (range, 80-130) mm Hg, and the drug requirement decreased from 3.9 +/- .6 (range, 2-5) to 1.1 +/- .9 (range, 0-3) (P value for all < .001). Complications included transient intrarenal arterial spasm in three patients, groin hematoma in two patients, and ipsilateral renal vein injury in one patient. At 22 months +/- 17 (range, 4-84 months) follow-up, the restenosis rate, as determined by recurrence of hypertension and angiographic demonstration of restenosis, was 16%.


CONCLUSIONS
Despite some technical problems, PTRA is safe and effective in treating renovascular hypertension caused by nonspecific aortoarteritis. The complication rate is low.
Sharma
S
S
Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Gupta
H
H
Saxena
A
A
Kothari
S S
SS
Taneja
K
K
Guleria
S
S
Rajani
M
M
D000293:Adolescent; D000800:Angioplasty, Balloon / Q000009:adverse effects; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D008297:Male; D011859:Radiography; D012077:Renal Artery; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology