Percutaneous transluminal angioplasty in the treatment of renovascular hypertension: sequential prospective study.

OBJECTIVE To evaluate the use of percutaneous transluminal renal angioplasty (PTRA) in the treatment of renal vascular hypertension. DESIGN Sequential prospective PTRA treatment of severe arterial hypertension, screening by the captopril test, confirmed by renal arteriography, and the result evaluated by post-PTRA arteriography, blood pressure measurement and renal function. SITE: Vascular Surgery, angioradiology sector, and Nephrology outpatients department of the Federal University of São Paulo-Paulista School of Medicine, São Paulo, Brazil, a tertiary health-care institution. PARTICIPANTS PTRA was employed on 32 patients screened by clinical examination, captopril test and renal arteriography. EVALUATION PTRA results were evaluated by the criteria of the Cooperative Study of Renovascular Hypertension. RESULTS After PTRA the completion arteriography showed no renal stenosis in 24 patients (75%), residual stenosis (20-50%) in 3 (9.4%) and no change in 5 (15.6%). The blood pressure results were: 3 patients (9.4%) were cured, 24 (75%) improved and 5 (15.6%) were unchanged. We observed normal renal function before and after PTRA in 25 patients (78%); altered pre- and improved post-PTRA in 2 (6.3%); post-PTRA remained unaltered in 2 (6.3%); and altered pre- and worsened post-PTRA in 3 (9.4%). Recurrence of stenosis occurred in one patient after 8 months. CONCLUSIONS PTRA is a convenient procedure, relatively safe and an effective complementary method of medical therapy for controlling renovascular hypertension.