STENOSES OF RENAL BRANCH ARTERIES IN FIBROMUSCULAR DYSPLASIA - RESULTS OF PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY

PURPOSE: To evaluate percutaneous transluminal renal angioplasty (PTRA ) in the treatment of renal branch artery stenoses caused by fibromusc ular dysplasia. MATERIALS AND METHODS: The authors retrospectively stu died the files of 20 consecutive hypertensive patients with 25 branch artery stenoses associated with 10 main renal artery lesions. Results at clinical and angiographic follow-up were assessed by means of life- table analysis. RESULTS: PTRA was technically successful in 21 of the 25 renal branch artery stenoses (84%). One of the technical failures w as treated by means of selective embolization. Nine of the 10 associat ed main renal artery lesions were successfully dilated, and the 10th w as improved. Immediately after PTRA, at 6-month follow-up, and at long -term follow-up, 70%, 76%, and 68% of the patients, respectively, were cured and 25%, 24%, and 16% were improved. Stenosis recurred in 9% of the branch arteries and was associated with clinical relapse; these a rteries were redilated, and all patients were considered cured at the second 6-month follow-up. CONCLUSION: PTRA should be considered the fi rst-line treatment for hypertension due to renal branch artery stenosi s in fibromuscular disease.