[Combined intravenous arteriography and pyelography in renovascular hypertension. II. Comparison of its cost-effectiveness ratio with that of the classical approach (i.-v. pyelography +/- Seldinger arteriography) (author's transl)].

The cost of the systematic radiological examination of 100 hypertensive patients in the search of renovascular hypertension reaches 118 330 F, for the classical approach based on selecting the indications of the Seldinger arteriography on the urographic signs and even 164 950 F when these indications are broadened. The systematic examination of 100 hypertensives by the combined intravenous arteriography and pyelography costs 108 240 F when only one film is taken and 120 910 F when 6 films are taken. The effectiveness for the diagnosis of the 11 renovascular diseases present in 100 hypertensive patients, is measured by the recognition of 8.6-9.1 of them by the classical approach and 10.4-10.9 by the combined intravenous arteriography and pyelography. The effectiveness for the diagnosis of the 2,3 cases of renovascular hypertension present in 100 hypertensive patients is measured by the recognition of 1.8 -1.9 of them by the classical approach and 2.1-2.27 by the combined IV arteriography and pyelography. The cost of finding a patient with curable renovascular hypertension is respectively 51 543 F and 53 264 F with the routine intravenous arteriography according to the number of films and 65 738 and 86 815 F for the classical approach according to wether the indications of the Seldinger arteriography have purely urographic or also clinical basis. In conclusion, the combined intravenous renal arteriography and urography is a method more reliable and less expensive to diagnose renovascular disease and hypertension than the classical approach selecting the seldinger arteriography on the urographic and clinical data. Furthermore, this technic prevents arterial catheterism complications and allows a non traumatic follow-up of the non operated stenosis which may threaten the life of the kidney, as well as the operated or dilated ones.