[Treatment of renal artery stenosis].

BACKGROUND

Treatment of renal artery stenosis with angioplasty may be performed in patients with renovascular hypertension, ischaemic renal failure, or to preserve renal function.

MATERIAL AND

METHODS

From 1982 to 1993 Rikshospitalet performed 591 renal angioplasties in 419 patients with significant renal artery stenoses. Clinical and angiographic follow-ups were performed up until 1996.

RESULTS

In patients with atherosclerotic disease, the acute success rate was 94%, primary patency 60%, and secondary patency 74%. The results were better for fibromuscular dysplasia. Patients with the highest blood pressure and those with recent onset of hypertension had the largest decrease in blood pressure. Renal angioplasty of bilateral stenosis or stenosis to a single functioning kidney preserved renal function in patients with normal to moderately reduced renal function. There were no overall positive effects on blood pressure and renal function in patients with serum creatinine > 250 mumol/l.

CONCLUSION

Renal angioplasty can be done in selected patients with renal artery stenosis. The selection of patients for renal angioplasty is important in order to increase the clinical success rate. Clinical as well as angiographic follow-ups for detection of restenosis are mandatory.