RENAL-ARTERY ANGIOPLASTY - TECHNICAL RESULTS AND CLINICAL OUTCOME IN 320 PATIENTS

Objective: To review the results of percutaneous transluminal renal ar tery angioplasty (PTRA), including technical success and clinical outc ome, at Mayo Clinic Rochester. Design: We retrospectively reviewed our experience with 320 patients who underwent PTRA for stenosis of 396 a rteries during a 14-year period. Material and Methods: We reviewed med ical records and angiograms of patients who underwent PTRA at Mayo Cli nic Rochester between January 1980 and December 1993. The patients wer e divided into four groups, based on clinical history and angiographic appearance of the stenosing lesion: renal artery atherosclerosis (ASO group), fibromuscular dysplasia (FMD group), previous renal artery by pass or endarterectomy, and renal artery stenosis in a solitary kidney . Technical results of the PTRA were determined by evaluation of angio grams obtained before and after the procedure. Data on patient demogra phics, blood pressure, antihypertensive medications, and serum creatin ine mere recorded for the period preceding PTRA, after the procedure, and at last follow-up. Results: All groups had statistically significa nt reductions in mean arterial pressure and anti-hypertensive medicati ons after PTRA. The percentage of patients who benefited after renal a rtery angioplasty was 70% for patients with ASO (8.4% cured), 63% for patients with FMD (22% cured), 53.8% for patients with prior surgical revascularization (23.1% cured), and 91.7% for patients with a solitar y kidney (0% cured). No significant overall change in serum creatinine level was noted after the procedure in any group. Complications were comparable to those reported in other studies. The 30-day all-cause mo rtality rate was 2.2% for the current study, all deaths occurring in t he ASO group. Conclusion: PTRA rarely leads to a ''cure'' of renovascu lar hypertension but provides effective control of blood pressure and decreases the medication requirements in selected patients.