Long term follow-up of percutaneous transluminal renal angioplasty with special reference to aorto-arteritis.

ABSTRACT

Percutaneous transluminal renal angioplasty (PTRA) was attempted in 96 patients of renovascular hypertension (RVHT) admitted during the period 1986 to 1992. The patients' age ranged from 14-70 (mean 38.7 +/- 18.8) years. There were 42 (43.8%) males and 54 (56.2%) females. The cause of renal artery stenosis (RAS) was aorto-arteritis in 44 (45.8%), atherosclerosis in 28 (29.2%) and fibromuscular dysplasia in 24 (25%). Bilateral RAS was found in 16 (16.7%). PTRA was angiographically successful in 92 (95.8%) patients. The mean pressure gradient decreased from 82.6 +/- 8.2 to 11.2 +/- 3.6 mm Hg in aorto-arteritis, 75.2 +/- 13.2 to 9.6 +/- 6.4 mm Hg in atherosclerosis and from 86.4 +/- 10.6 to 13.2 +/- 8.2 mm Hg in fibromuscular dysplasia respectively. The patients were followed up for 43.2 +/- 24.1 (range 6-77) months. Remission or satisfactory lowering of blood pressure was achieved in 80 (86.9%) patients. Clinical success rate (remission or satisfactory lowering of BP) at the end of follow-up period was 75.3 percent. Randomly selected repeat angiography was done in 45 out of 92 (49.1%) patients at the end of 24 months of follow-up. Restenosis was detected in 12 (26.7%) patients and was commonest in the atherosclerotic group (42.8%), followed by fibromuscular dysplasia (14.3%) and least common in aorto-arteritis (11.8%). Repeat angioplasty was done successfully in 10 (83.3%) patients.(ABSTRACT TRUNCATED AT 250 WORDS)