[Renal angioplasty in the treatment of renovascular hypertension. A comparison of results and the authors' own experience].

From 1986 to 1989, 68 patients with 79 stenoses (11 bilateral, 4 unilateral) underwent renal angioplasty in the Radiology Departments of Udine (34 cases) and Pisa (34 cases). Fifty-eight patients were arteriosclerotic (mean age 58) and 21 fibrodysplastic (mean age 32). The fibrodysplastic lesions were treated in Pisa. Recovery was obtained in 64/68 patients and 75/79 stenoses (residual stenosis less than 20%). Renovascular hypertension was cured or reduced in 57/64 cases. The angiographic follow-up (mean 15 months) of 54/75 stenoses demonstrated recurrence in 2/19 fibrodysplastic and in 6/35 arteriosclerotic lesions; 2 patients underwent angioplasty and 2 surgery: one patient per group exhibited no change in hypertension values. Thus, we believe that hypertension should be better defined (e.g. by selective reninemia sampling and Ace-inhibitor renal scintigraphy). The follow-up (mean 22 months) of hypertension in 48/64 patients (arteriosclerotic: fibrodysplastic = greater than 33/15) showed complete recovery in 8/33 and in 10/15 cases (24% and 66%, respectively); a significant improvement was obtained in 15/33 and in 2/15 cases (45% and 14%, respectively). Our results confirmed the higher efficacy of renal angioplasty in the treatment of fibrodysplastic lesions; as for arteriosclerotic lesions, angioplasty has been observed to improve vascularization rather than to cure hypertension.