PTA OF RENAL-ARTERY STENOSIS - THERAPY OF ARTERIAL-HYPERTENSION AND KIDNEY-PRESERVATION

Percutaneous transluminal angioplasty (PTA) is the method of choice in the treatment of renovascular hypertension due to renal artery stenosis (RAS). In addition, PTA was shown to improve reduced renal function in patients with severe RAS in order to avoid imminent loss of the kidney. The aim of this study was to evaluate PTA results and effects on arterial hypertension and renal function. From this data conclusions should be drawn to optimize radiological interventional strategies. In 90 patients (male n = 52, female n = 38, age 15-84) PTA was performed in a total of 115 RAS (arterioscl. [AS] n = 71, fibromusc. dysplasia [FMD] n = 16, unilat. n = 68, bilat. n = 14, single kidney n = 5, renal transplant n = 2, aortorenal bypass n = 1). Serum creatinine was normal in 53 patients and elevated (> 1.4 mg%) in 21 patients. Technical success rate of PTA was 84% (97/115). Severe complications occurred in 5.5% (5/90) requiring an emergency surgical intervention in 3 cases. Follow-up (4-52 months) demonstrated a blood pressure response normalized in 26% (19/73), improved in 44% (32/73), and unchanged in 30% (22/73). Serum creatinine decreased in 8/21 cases (mean 0.8 mg%), remained unchanged in 7/21, and increased in 6/21 (mean 1.8 mg%). Our data showed that PTA results were favourable in patients with FMD vs. AS, 50% vs. 75% residual narrowing of renal artery following dilatation, and normal vs. elevated serum creatinine.