Salvador M, Chamontin B
Arch Mal Coeur Vaiss. 1986 Jun;79(6):847-50.
The purpose of the study was to analyse the effects on stenosis and blood pressure of percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma. Angioplasty was successfully performed in ten hypertensive patients (seven men and three women) with unilateral (seven patients) or bilateral (three patients) renal artery stenoses: dilation without complication, anatomic technical success in each case, and reduction in mean pick systolic-pressure across the stenosis. Recurrent stenoses were demonstrated in three men during the first year. After three years (mean follow-up), six patients were improved (normotensive under treatment), but all patients received an antihypertensive drug. Four failures were observed, due to recurrent stenosis in three cases. In patients with unilateral, non ostial and non completely occluded stenosis, improvement due to successful angioplasty was generally observed, incidence of recurrent stenosis was about 20 per cent. In contrast, neither cure nor improvement can be expected in patients with advanced bilateral atheromatous renal artery stenoses. A randomised trail appears necessary to demonstrate the potential improvement of renal function after angioplasty. Our results suggest that percutaneous transluminal renal angioplasty is effective for long-term control of renovascular hypertension (75 per cent) in patients with unilateral, non ostial, atheromatous artery stenosis.
本研究的目的是分析经皮腔内肾血管成形术对动脉粥样硬化所致肾血管性高血压患者狭窄和血压的影响。对10例高血压患者（7例男性，3例女性）进行了血管成形术，这些患者存在单侧（7例）或双侧（3例）肾动脉狭窄：扩张过程无并发症，每例解剖技术成功，狭窄处平均收缩压降低。3名男性在第一年出现再狭窄。三年后（平均随访期），6例患者病情改善（治疗后血压正常），但所有患者均服用降压药。观察到4例失败，3例因再狭窄所致。对于单侧、非开口处且非完全闭塞性狭窄的患者，通常可观察到因血管成形术成功而病情改善，再狭窄发生率约为20%。相比之下，对于双侧晚期动脉粥样硬化性肾动脉狭窄患者，无法预期治愈或病情改善。似乎有必要进行一项随机试验，以证明血管成形术后肾功能的潜在改善。我们的结果表明，经皮腔内肾血管成形术对于单侧、非开口处、动脉粥样硬化性动脉狭窄患者的肾血管性高血压长期控制有效（75%）。
