LONG-TERM RESULTS OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN RENOVASCULAR HYPERTENSION

Purpose: The long-term effect of percutaneous transluminal renal angio plasty (PTRA) was assessed in 50 patients with renovascular hypertensi on. Material and Methods: Thirty-eight of the patients had atheroscler otic disease and 12 patients fibromuscular dysplasia (FMD). Dilatation with a balloon catheter was per formed at 6 to 8 atm for 15 to 30 s. Results: PTRA was technically successful in 46 (92%) patients. Three o f the failures underwent surgical revascularization. There was no mort ality connected with PTRA. Minor complications occurred in 6 (12%) pat ients, and surgical intervention was required in 1. In 3 patients with restenosis, repeated PTRA was performed in 2, and surgery in the othe r 2 patients. Bilateral disease occurred in 12 patients, and 3 had seq uential bilateral PTRA. In 9 patients with atherosclerotic ostial sten osis, PTRA was technically successful in 8 (89%). Thirty-eight patient s were re-examined with a mean follow-up of 4 years. Ar follow-up, 5 ( 45%) of the patients with FMD were classified as cured, 6 (55%) as imp roved, and none as failed. In the 27 patients with atherosclerotic dis ease, 23 (85%) had long-term benefit, 3 (11%) were cured, 20 (74%) wer e improved, and 4 (15%) were failures. In the 8 patients with ostial a therosclerotic lesions and successful PTRA, there was a 75% long-term benefit. Two patients died during follow-up! both from myocardial infa rction. Conclusion: The results suggest that PTRA is effective in long -term management of renovascular hypertension, not only in patients wi th fibromuscular stenosis, but also in patients with atherosclerotic d isease, even when ostial lesions are present.