Clinical results of percutaneous transluminal renal angioplasty in 113 hypertensive patients

The aim of the study was to evaluate the clinical results of percutaneous t ransluminal renal angioplasty in a population of 113 consecutive hypertensi ve patients who underwent endoluminal revascularization for angiographicall y significant renal artery stenosis. Retrospective analysis of the case rec ords of 104 patients showed that systolic blood pressure (SBP) and diastoli c blood pressure (DBP) decreased significantly 6 months after angioplasty ( -20.9 mmHg and -8.4 mmHg respectively; p=0.0001). This decrease was maintai ned until 19.8 months after the procedure. In cases with suboptimal revascularization (persistence of a residual steno sis more than 30%), only the SEP decreased significantly at 6 months (from 177 mmHg to 156.1 mmHg : p=0.0061): when DBP decreased from 91.4 mmHg to 86 .1 mmHg (NS) at 6 months, and fell to 80.9 mmHg (p=0.026) at 19.8 months (a fter the performance of a second transluminal angioplasty for 41% patients of this group due to restenosis). Twenty-nine patients presented a restenosis of the renal artery 6 months af ter the initial procedure. In this group, only SEP decreased significantly at 6.1 months and at 18.7 months (from 171.9 mmHg to 156.1 mmHg and 146.5 m mHg respectively; p=0.0064 and p=0.0001). DBP decreased significantly only at 18.7 months (-12.6 mmHg; p=0.0001), after a second renal angioplasty in 23 patients (79%). In the 60 patients without restenosis at 6 months, SBP a nd DBP decreased significantly at 6.1 and 18.7 months. No significant Varia tion of creatinine levels was observed. These results confirm the utility of percutaneous transluminal renal angiop lasty for the treatment of renovascular hypertension.