Treatment of Severe Renovascular Hypertension by Percutaneous Transluminal Renal Angioplasty in Patients with Solitary Functioning Kidney

Abstract

In this study the effects of percutaneous transluminal renal angioplasty on blood pressure and renal function were studied in 9 hypertensive patients with stenosis of the main artery of a solitary functioning kidney. The outcome of the percutaneous dilatation of the renal artery stenosis, and the effects on blood pressure and renal function were evaluated for a mean period of 16.4 ± 2.13 (SE) months (ranging from 3 to 65 months). A successful dilatation of the renal artery stenosis was shown in all the patients by the aortography performed 1 h after the procedure. At the discarge (7.8 ± 0.9 days after dilatation), blood pressure was ‘cured’ in 2 patients and ‘improved’ in the remaining patients; renal function was improved in all patients who had reduced renal function. At the last follow-up, no restenosis was found in patients who repeated the follow-up angiography; blood pressure was ‘cured’ in 3 patients and ‘improved’ in 6 patients, and renal function appeared steadly improved. In contrast with other reports, our results demonstrate that percutaneous renal angioplasty is a safe and effective procedure and should be attempted before considering surgical intervention in patients with artery stenosis of a solitary functioning kidney.

Sustained beneficial effects on blood pressure during long time retrospective follow-up after endovascular treatment of renal artery occlusion

“…PTRA could therefore well be attempted before considering surgical intervention on patients with solitary functioning kidneys. [5][6][7][8] In patients with chronic renal insufficiency and global obstructive atherosclerotic vascular disease, PTRA and stenting of renal artery stenosis has been shown to improve or stabilise renal function and to preserve kidney size, 9 and Shannon et al 10 have advocated stenting as a relatively safe procedure to salvage a solitary kidney. Repeated PTRA and stent placement have previously been reported to be effective treatment for total RAO after prior unsuccessful balloon angioplasty.…”