[PP.25.17] EFFECT OF RENAL ARTERY ANGIOPLASTY ON AMBULATORY BLOOD PRESSURE IN PATIENTS WITH RESISTANT HYPERTENSION AND ATHEROSCLEROTIC RENAL ARTERY STENOSIS

2017 ◽  
Vol 35 ◽  
pp. e301
Author(s):  
P.Y. Courand ◽  
M. Dinic ◽  
A. Lorthioir ◽  
G. Bobrie ◽  
M. Sapoval ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Ambulatory Blood Pressure ◽  
Resistant Hypertension ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

scholarly journals Clinical response scores to predict blood pressure and renal function improvement following renal artery stenting for atherosclerotic renal artery stenosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Kablak-Ziembicka ◽  
A Roslawiecka ◽  
R Badacz ◽  
A Sokolowski ◽  
P Musialek ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Predictive Models ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Baseline Serum ◽  
Kidney Length

Abstract Background It is little known about predictors of systolic (SBP) and diastolic (DBP) blood pressure or renal function (eGFR) improvement in patients with atherosclerotic renal artery stenosis (ARAS) undergoing stent-assisted angioplasty (PTA). Therefore, we aimed to build a prediction scores that would indicate characteristics of patient subsets with ARAS most likely to have clinical improvement following PTA. Methods 201 patients who underwent PTA for ARAS (2003–2018) were categorized as eGFR or SBP/DBP responders based on eGFR increase of ≥11 ml/min/1.73m2, decrease of SBP ≥20mmHg and DBP ≥5mmHg at 12-months following PTA. The remaining patients were classified as non-responders. The performance of logistic regression models were evaluated by basic decision characteristics. Continuous data have been transformed into binary coding with help of operating characteristic (ROC) curve. Predictive models have been constructed for each followed by construction of predictive models in each of 3 categories. Results Logistic regression analysis showed that: baseline SBP>145 mmHg, DBP >82 mmHg, previous myocardial infarction and Renal-Aotric-Ratio >5.1 were independent influencing factors of SBP response, with relative risk percentage shares of 69.8%; 12.1%; 10.9%; and 7.2%, respectively (sensitivity: 82%, specificity: 86.3%, positive (PPV):82% and negative (NPV) predictive values: 86.3%). The DBP decrease prediction model included baseline SBP >145 mmHg and DBP >82 mmHg, the ARAS progression, index kidney length >106 mm, and bilateral PTA with respective shares of 35.0%; 21.8%; 18.2%; 13.3% and 11.8%. (sensitivity: 76%, specificity: 77.8%, PPV: 80.7% and NPV: 72.6%). The eGFR increase was associated with baseline serum creatinine >122 μmol/L but eGFR greater than 30 ml/min/1.73m2, index kidney length >98 mm, end-diastolic velocity in index renal artery, renal resistive index <0.74, and requirement for >3 BP medications, with respective shares of 24.4%; 24.4%; 21.2%; 15% and 15% (sensitivity: 33.3%, specificity: 93.5%, PPV: 65.6% and NPV: 78.9%). Conclusions Current study identified clinical characteristics of patients who most likely to respond to PTA for ARAS. The sutability of the score should be verified in a prospective cohort of patients referred to PTA of ARAS Funding Acknowledgement Type of funding source: None

scholarly journals Blood Pressure Outcome of Angioplasty in Atherosclerotic Renal Artery Stenosis

Hypertension ◽  
1998 ◽  
Vol 31 (3) ◽  
pp. 823-829 ◽  
Author(s):  
Pierre-François Plouin ◽  
Gilles Chatellier ◽  
Bernadette Darné ◽  
Alain Raynaud
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

OUTCOME OF BLOOD PRESSURE AND RENAL FUNCTION AFTER PTRA AND STENTING OF ATHEROSCLEROTIC RENAL ARTERY STENOSIS

2004 ◽  
Vol 22 (Suppl. 1) ◽  
pp. S158
Author(s):  
S. Tedoldi ◽  
R. Quartagno ◽  
C. Lanzani ◽  
M T. Sciarrone ◽  
S. Fattori ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

scholarly journals Resistant Hypertension and Atherosclerotic Renal Artery Stenosis

Hypertension ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 1516-1523 ◽  
Author(s):  
Pierre-Yves Courand ◽  
Miriana Dinic ◽  
Aurélien Lorthioir ◽  
Guillaume Bobrie ◽  
Christine Grataloup ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Resistant Hypertension ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

Blood pressure, antihypertensive medication, and atherosclerotic renal artery stenosis

1999 ◽  
Vol 33 (4) ◽  
pp. 675-681 ◽  
Author(s):  
Michael J. Tullis ◽  
Michael T. Caps ◽  
R.Eugene Zierler ◽  
Robert O. Bergelin ◽  
Nayak Polissar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Antihypertensive Medication ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis

scholarly journals Long-Term Renal and Cardiac Outcomes after Stenting in Patients with Resistant Hypertension and Atherosclerotic Renal Artery Stenosis

2017 ◽  
Vol 42 (5) ◽  
pp. 774-783 ◽  
Author(s):  
Cristiana Catena ◽  
GianLuca Colussi ◽  
Gabriele Brosolo ◽  
Nicolas Verheyen ◽  
Marileda Novello ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Resistant Hypertension ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Cardiac Outcomes

scholarly journals "Flash" pulmonary oedema as a clinical manifestation of renovascular hypertension

2003 ◽  
Vol 131 (5-6) ◽  
pp. 208-210 ◽  
Author(s):  
Dimitra Kalimanovska-Ostric ◽  
Branislava Ivanovic ◽  
Vladimir Ostric ◽  
Vesna Knezevic ◽  
Vesna Stojanov ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Abdominal Aortic Aneurysm ◽  
Renal Artery ◽  
Pulmonary Oedema ◽  
Renal Artery Stenosis ◽  
Left Ventricular ◽  
Artery Stenosis ◽  
Atherosclerotic Renal Artery Stenosis ◽  
Renal Revascularization ◽  
Abdominal Aortic

One of the clinical manifestations of renovascular hypertenzion (RVH) may be a recurrent pulmonary oedema both in the absence or in the presence of systolic left ventricular dysfunction. This type of pulmonary oedema characterized as "flash" pulmonary oedema is ascribed to elevated angiotensin II concentrations with consequent hypertension as well as to volume overload resulting from decreased pressure natriuresis when there are significant stenoses of both or one renal arteries. The investigation included 30 patients with RVH treated by percutaneous transluminal angioplasty of the stenosed renal artery (PTRA) and/or stent implantation (PTR-ST) and 30 patients with surgical resection of the abdominal aortic aneurysm (AAA). The first group was divided in two subgroups according to the etiology of renal artery stenosis (RAS). In the subgroup with fibromuscular dysplasia (FMD) the mean age was 37.5 years, in the subgroup with atherosclerotic renal artery stenosis (ARAS) 54.8 years and in the group with operated AAA 68.6 years. There were more females than males only in the FMD subgroup (10:3). Two patients of the first group experienced pulmonary oedema, both in the subgroup with atherosclerotic renal artery stenosis associated with atherosclerosis of other arteries. Normalization of the blood pressure following PTRA in both and an uncomplicated course after a surgical myocardial revascularization in one of them illustrates the importance of renal revascularization. Pulmonary oedema occurred preoperatively in four out of 30 patients with abdominal aortic aneurysm in whom significant renal artery stenoses coexisted. Two patients died despite surgery, one patient is clinically stable and the medicament treatment of heart failure is inevitable in the fourth with a left ventricular aneurysm following myocardial infarction. The occurrence or reoccurrence of pulmonary oedema in the absence of other explanation should suggest the possibilty of billateral or unilateral renal artery stenosis requiring renal revascularization for blood pressure regulation as well as for elimination of other manifestations/complications.

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