RESULTS OF RENAL ANGIOPLASTY IN NONSPECIFIC AORTOARTERITIS (TAKAYASU-DISEASE)

PURPOSE: To evaluate the long-term results of percutaneous translumina l renal angioplasty (PTRA) in the management of renovascular hypertens ion caused by nonspecific aortoarteritis (Takayasu disease). MATERIALS AND METHODS: The results of 96 stenoses in 66 patients were retrospec tively studied. The indications for PTRA included hypertension uncontr olled by single-drug therapy, evidence of greater than 70% diameter st enosis in the renal artery with a peak systolic gradient of greater th an 20 mm Hg, and clinically inactive disease. RESULTS: Technical succe ss was obtained in 91 (95%) stenoses in 62 patients. Clinical success was seen in 59 (89%) and included ''cure'' in 14 and ''improvement'' i n 45 patients. The stenosis decreased from 88% +/- 6% (range, 70%-100% ) to 11% +/- 12% (range, 0%-40%), systolic pressure gradient decreased from 95 mm Hg +/- 22 (range, 30-140 mm Hg) to 9 mm Hg +/- 8 (range, 0 -30 mm Hg), blood pressure improved from 181 +/- 16 (range, 150-220)/1 15 +/- 10 (range, 90-146) to 136 +/- 25 (range, 130-210)/86 +/- 16 (ra nge, 80-130) mm Hg, and the drug requirement decreased from 3.9 +/- .6 (range, 2-5) to 1.1 +/- .9 (range, 0-3) (P value for all <.001). Comp lications included transient intrarenal arterial spasm in three patien ts, groin hematoma in two patients, and ipsilateral renal vein injury in one patient. At 22 months +/- 17 (range, 4-84 months) follow-up, th e restenosis rate, as determined by recurrence of hypertension and ang iographic demonstration of restenosis, was 16%. CONCLUSION: Despite so me technical problems, PTRA is safe and effective in treating renovasc ular hypertension caused by nonspecific aortoarteritis. The complicati on rate is low.