ABSTRACT
OBJECTIVE: analysis of Doppler Duplex (DD) contribution to renal artery percutaneous angioplasty (ATL) follow-up. METHOD: between 1983 and 1989, SO ATL were performed in 47 subjects with renovascular hypertension. Their average age was 50 +/- 12 years. The lesions were fibromuscular dysplasia (n = 20) and atherosclerosis (n = 27). The DD was performed simultaneously with arteriography (A degrees) (considered the gold standard), when the stenosis was discovered (n = 32), before (n = 32) and after (n = 39) ATL, and during the follow-up between the 6th and 12th month (n = 38). RESULTS: during the initial exploration, the concordance between DD and A degrees is 78% and the sensitivity of DD for the diagnosis of stenosis is 90%. ATL was performed once on the basis of DD alone, that showed a tight and significant stenosis with dysplasia, when A degrees failed to detect it. ATL confirmed the lesion and was successful, and hypertension cured. The concordance DD-A degrees before and after ATL is respectively 88% and 77%. At the late control, the concordance is 92%, the sensitivity 73% and the specificity 85% for all stenosis. While maintaining a good specificity, DD recognized the 3 tight found by the A degrees control. The complications encountered during ATL were diagnosed by DD most of the time: all the local complications at the site of entry (n = 5), all the dissections with obliteration (n = 2) and 5 of the 8 dissections without obliteration of the renal artery. CONCLUSION: the detection and the lesional assessment of post-ATL complications are facilitated by DD. The good sensitivity of DD combined with satisfactory specificity will allow the reduction of angiographic surveillance by taking advantage of a non-invasive method.