Renal artery digital-subtraction angiography. An outpatient investigation for renovascular hypertension.

The adequacy and convenience of the digital-subtraction angiographic procedure by means of a Diasonics DF100 as an investigation in renovascular disease were assessed over a nine-month period in 82 sequential renal artery studies, of which 76 were carried out in patients referred for the investigation of hypertension. Contrast medium was injected as a bolus by way of a centrally placed venous catheter, or a small (5 French size or smaller) arterial catheter. Patients tolerated the procedure well, and were fully mobile within 10 minutes to one hour (venous injection) and within two hours (arterial injection) after the procedure. Of the 82 studies, nine were judged as inadequate. All technical failures occurred with the venous injection technique. Of the 76 patients with hypertension, the main renal artery was judged as normal in 61. Renal artery lesions were demonstrated in 15 studies (13 patients). Renal vein renin studies, and the clinical or postoperative course supported the diagnosis of renovascular hypertension in 11 of these. Digital-subtraction angiography of the renal artery is a useful investigation in suspected renovascular hypertension. Its major advantage over conventional angiography is that it can be performed on an outpatient basis.