TREATMENT OF RENOVASCULAR HYPERTENSION WITH PERCUTANEOUS TRANSLUMINALANGIOPLASTY - EXPERIENCE IN SPAIN

PURPOSE: The clinical results of percutaneous transluminal angioplasty (PTA) were evaluated in patients with renovascular hypertension, and the effect of PTA on blood pressure and renal function was determined. PATIENTS AND METHODS: Between February 1982 and December 1990, 93 hyp ertensive patients underwent 123 renal artery PTA procedures. Mean pat ient age was 43.4 years (range, 12-78 years). Average baseline blood p ressure was 162/111 mm Hg (range, 140-230 /95-150 mm Hg). The cause of renovascular hypertension, as determined with angiography, was athero sclerosis in 37 patients, fibromuscular dysplasia in 27, and mixed dis ease in one; 28 patients had renal transplant arterial stenosis. RESUL TS: In patients with atherosclerotic renal vascular disease or fibromu scular renal artery stenosis, systolic and diastolic blood pressure de creased significantly (P < .001) at 96 months after PTA. In patients w ith renal transplant arterial stenosis, blood pressure also decreased significantly (P < .001) at 12 months after PTA. Technical success was achieved in 78% of patients with atherosclerosis, 92% of patients wit h fibromuscular dysplasia, and 76% of patients with renal transplants. Complications were seen in 4.8% and were related to renal failure and vessel dissection. CONCLUSION: PTA is the therapy of choice in patien ts with renovascular hypertension due to fibromuscular dysplasia. Pati ents with atherosclerotic renal artery stenosis or stenosis of a renal artery in a transplanted kidney should be selected according to the a natomy of the lesion and clinical patient characteristics.