scholarly journals IMPACT OF PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY ON LEFT VENTRICULAR MASS AND ITS RELATIONSHIP TO CARDIOVASCULAR OUTCOME IN HYPERTENSIVE PATIENTS WITH RENAL ARTERY STENOSIS

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e301
Author(s):  
Yoshio Iwashima ◽  
Tetsuya Fukuda ◽  
Takeshi Horio ◽  
Hiroshi Kusunoki ◽  
Shin-Ichiro Hayashi ◽  
...  
1993 ◽  
Vol 60 (1) ◽  
pp. 27-33
Author(s):  
M. Takeda ◽  
Y. Katayama ◽  
K. Saito ◽  
T. Tsutsui ◽  
T. Komeyama ◽  
...  

Tc99m-dimercaptosuccinic acid renal uptake (DMSA uptake) was examined to assess the changes in split renal function following percutaneous transluminal renal angioplasty (PTRA) in 9 patients with a total of 12 renal artery stenoses and renovascular hypertension (RVH). The results were studied with respect to age, degree of renal artery stenosis, and renal vein renin ratio (RVRR) before PTRA. Although the degree of renal artery stenosis, systolic blood pressure, and peripheral blood plasma renin activity were improved 3 months after PTRA, neither the DMSA uptake of the affected kidneys nor that of the contralateral kidneys improved. Although restenosis occurred during the long follow-up period in one patient, DMSA uptake did not change in parallel with the degree of stenosis or RVRR. The degree of improvement in DMSA uptake, blood pressure, and plasma renin activity after PTRA in patients aged under 70 years was significantly higher than that in patients 70 years or older. Good improvement of renal function was attained in a 4-year-old boy, despite the fact that split renal function prior to PTRA was so poor that nephrectomy had been considered instead of PTRA. These results suggest that several factors before PTRA, such as DMSA uptake, degree of renal artery stenosis, and RVRR, are not absolutely predictive of results after PTRA, and that the effect of PTRA on blood pressure and renal function is greater in younger patients.


VASA ◽  
2006 ◽  
Vol 35 (3) ◽  
pp. 147-155 ◽  
Author(s):  
Zeller

Renal artery stenosis may cause or deteriorate arterial hypertension and/or renal insufficiency. Technical improvements of diagnostic and interventional endovascular tools have lead to a more widespread use of endoluminal renal artery revascularization and extension of the indications for this type of therapy. Since the first renal artery angioplasties performed by Felix Mahler and Andreas Grüntzig in 1978, numerous single centre studies have reported the beneficial effect of percutaneous transluminal renal angioplasty, and since the early 1990’s stenting of renal artery stenosis caused either by atherosclerosis or fibromuscular dysplasia. This article summarizes the impact of technical improvements of endovascular tools on interventional techniques during the last decade and gives an overview concerning the clinical impact of renal artery revascularization. Despite the absence of sufficient randomized studies there is nonetheless evidence that stenting of hemodynamically relevant atherosclerotic renal artery stenosis has an impact on blood pressure control, renal function, and left ventricular hypertrophy.


2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Tetsutaro Matayoshi ◽  
Kei Kamide ◽  
Ryoichi Tanaka ◽  
Tetsuya Fukuda ◽  
Takeshi Horio ◽  
...  

Background. The results of recent trials have brought some confusion to the treatment strategy for renal artery stenosis (RAS). To evaluate the applicability of percutaneous transluminal renal angioplasty (PTRA) for RAS, we extracted the factors that may affect the effectiveness of PTRA from cases experienced at a hypertension center. Methods and Results. We retrospectively assessed the blood pressure (BP) lowering effects and renoprotective effects in 50 consecutive patients that had hemodynamically significant RAS and had undergone PTRA and stenting during 2001–2005. Subjects were diagnosed with atherosclerotic RAS (42), fibromuscular dysplasia (6), or Takayasu disease (2). After PTRA, BP significantly lowered from 152.3/80.3 mmHg to 132.6/73.2 mmHg (p<0.05), but the estimated glomerular filtration rate (eGFR) did not change significantly. There were no factors associated with the BP lowering effects of PTRA. The baseline resistive index (RI) was negatively correlated with the change in eGFR (p<0.05). After correction for age, sex, BMI, and the dose of contrast medium, the association of RI with change in eGFR remained significant. Conclusion. In cases with hemodynamically significant RAS, PTRA lowered BP but was not effective in improving renal function. Higher baseline RI may be a factor for predicting poor clinical course of renal function after PTRA.


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