Percutaneous Transluminal Angioplasty for Severe Renovascular Hypertension Due to Renal-Artery Medical Fibroplasia

Millan, V G; MADIAS, N

doi:10.1016/s0140-6736(79)92751-x

Cited by 35 publications

(1 citation statement)

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“…15 - 17 In patients with hypertension associated with fibromuscular disease of the renal arteries, excellent technical and long-term functional outcomes have been reported by us and others. 1718 These results have established PTRA as the treatment of choice for the initial management of patients with renovascular hypertension secondary to fibromuscular dysplasia.…”

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Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension: results in 100 patients.

et al. 1989

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The long-term effect of percutaneous transluminal renal angioplasty (PTRA) on blood pressure and renal function was assessed in 100 consecutive patients with atherosclerotic renovascular hypertension. Technical success rates (complete plus partial) of a first PTRA averaged 76.2%, 74.1%, and 67.7% for the unilateral (n=42), bilateral (n=27), and solitary (n=31) groups, respectively. Of the technical successes, 59% (43/73) experienced sustained blood pressure benefit (mostly amelioration) during a mean foUow-up period of 29 months. Rates of blood pressure benefit were similar in the three groups. Ostial lesions comprised the majority of blood pressure benefit failures. Repeat angioplasty in 14 patients resulted in a 71% technical success rate and a 50% blood pressure benefit rate during a mean follow-up period of 22 months. Long-term stability of mean serum creatinine level was observed after technically successful angioplasty in all three groups. Acute renal insufficiency, which was reversible in all but one patient, complicated 26% of the procedures. Mechanical complications occurred in 14% (20/145) of the arteries acted on; surgical intervention was required in five patients. The mortality rate was 2%. These results suggest that angioplasty is effective in both the long-term management of renovascular hypertension and the preservation of renal function hi a large fraction of patients with atherosclerotic renovascular hypertension. Among patients with accelerated or malignant hypertension, the prevalence of renovascular hypertension is about 30%. Moreover, it is estimated that up to 45% of patients with accelerated hypertension and renal insufficiency suffer from renovascular hypertension.

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Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension: results in 100 patients.

et al. 1989

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Percutaneous transluminal renal angioplasty. A potentially effective treatment for preservation of renal function

Madias¹,

Kwon²,

Millan³

1982

Archives of Internal Medicine

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Percutaneous transluminal renal angioplasty (PTRA) was performed in a group of 12 patients with marked renal functional impairment, severe hypertension, and critical renovascular stenoses in a solitary functioning kidney (ten patients) or bilaterally (two patients). The procedure led to least partial dilation in 11 of the 13 stenoses acted on and stabilization or modest improvement in renal function in seven of the 11 patients in whom some technical success had been achieved. Moreover, the severity of the patients' hypertension appeared to be favorably affected following PTRA. Complications that were encountered included three episodes of nonoliguric acute renal failure, a thrombotic occlusion of a renal artery, a tear of the balloon segment of the catheter requiring femoral arteriotomy, and an episode of gastrointestinal tract bleeding. Percutaneous transluminal renal angioplasty may be an effective modality in the treatment of patients with severe renovascular stenosis, renal functional impairment, and hypertension.

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Transluminal Angioplasty of the Iliac and Femoropopliteal Arteries

Waltman¹,

Greenfield²,

Novelline³

et al. 1982

Arch Surg

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Percutaneous Transluminal Angioplasty for Severe Renovascular Hypertension Due to Renal-Artery Medical Fibroplasia

Cited by 35 publications

References 4 publications

Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension: results in 100 patients.

Percutaneous transluminal renal angioplasty in management of atherosclerotic renovascular hypertension: results in 100 patients.

Percutaneous transluminal renal angioplasty. A potentially effective treatment for preservation of renal function

Transluminal Angioplasty of the Iliac and Femoropopliteal Arteries

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