Transvenous digital subtraction angiography (DSA) for diagnostic control following percutaneous transluminal angioplasty (PTA) in patients with renovascular hypertension.

Transvenous digital subtraction angiography (DSA) of the kidneys has shown to be useful in detection of renovascular abnormalities in hypertensive patients. In this study DSA was performed in 27 patients (fibrom. dyspl. n = 12, arterioscl. n = 15) following percutaneous transluminal angioplasty (PTA) of renal artery stenosis. Concerning PTA-effect on blood pressure, patients were classified in 3 groups (normal n = 13, improved n = 10, failure n = 4). DSA images and simultaneously determined effective renal plasma flow (ERPF) were correlated with response of blood pressure to PTA. The results demonstrate the usefulness and accuracy of transvenous renal DSA-imaging in follow-up studies. Normal ERPF correlated with a completely re-opened renal artery and normal renal parenchyma in DSA in normotensive patients. In patients with persistent or recurrent hypertension (n = 14) ERPF was reduced in 10 cases and DSA demonstrated disorders such as peripheral renal infarction or reduced renal size (n = 6) and re-stenosis (n = 2).