[Percutaneous transluminal angioplasty in atheromatous stenosis of the renal artery. Late results].

The purpose of the study was to analyse the effects on stenosis and blood pressure of percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma. Angioplasty was successfully performed in ten hypertensive patients (seven men and three women) with unilateral (seven patients) or bilateral (three patients) renal artery stenoses: dilation without complication, anatomic technical success in each case, and reduction in mean pick systolic-pressure across the stenosis. Recurrent stenoses were demonstrated in three men during the first year. After three years (mean follow-up), six patients were improved (normotensive under treatment), but all patients received an antihypertensive drug. Four failures were observed, due to recurrent stenosis in three cases. In patients with unilateral, non ostial and non completely occluded stenosis, improvement due to successful angioplasty was generally observed, incidence of recurrent stenosis was about 20 per cent. In contrast, neither cure nor improvement can be expected in patients with advanced bilateral atheromatous renal artery stenoses. A randomised trail appears necessary to demonstrate the potential improvement of renal function after angioplasty. Our results suggest that percutaneous transluminal renal angioplasty is effective for long-term control of renovascular hypertension (75 per cent) in patients with unilateral, non ostial, atheromatous artery stenosis.