DISCREPANCY OF CLINICAL AND ANGIOGRAPHIC RESULTS IN THE FOLLOW-UP OF PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY (PTRA)

Background: To investigate the value of recurrent hypertension as indi cator for renal artery patency after PTRA clinical and angiographic fo llow-up results were analysed. Patients and methods: results of 66 fol low-up angiographies and blood pressure measurements were available in 55 patients after technically and clinically successful PTRA. Out of 43 patients with atherosclerosis, in 33 was recurrent hypertension pre sent, and in ten patients none. Of 12 angiographies in patients with f ibromuscular dysplasia nine were done because of recurrent hypertensio n. Results. In atherosclerosis, 21 (64 %) out of 33 patients with recu rrent hypertension showed a re-stenosis by > 70 %, and 12 (36 %) none. Out of the ten follow-up angiographies performed in patients with no recurrence, two showed an unexpected stenosis. fibromuscular dysplasia , stenoses were present in seven cases (77 %). Four of them were at th e site of PTRA (44 %), while three were at a new site (33 %). The foll ow-up angiographies in three patients with no recurrence showed patent arteries. Out of 11 further angiographies carried out because of hype rtension after repeated PTRA, only three revealed restenosis. Conclusi ons: III only about 35 % of all patients with recurrent hypertension r e-stenosis was shown in angiography bur in 15 % of asymptomatic patien ts. Recurrence of hypertension after PTRA and renal artery stenosis is not well correlated. Thus, follow-up should be performed not only cli nically bur also by direct examination of renal artery patency such as by ultrasound.