Fournier A, Cécile J P, Rémond A, Hardin J M, Andréjak M, Makdassi R, Grumbach Y, de Frémont J F
Ann Med Interne (Paris). 1980;131(5):272-7.
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.
对100例高血压患者进行系统性放射学检查以寻找肾血管性高血压，采用基于尿路造影征象选择Seldinger动脉造影适应症的经典方法，费用达118330法郎；若扩大这些适应症，费用甚至高达164950法郎。对100例高血压患者进行静脉动脉造影和肾盂造影联合检查，仅拍摄一张片子时费用为108240法郎，拍摄6张片子时费用为120910法郎。对于100例高血压患者中存在的11种肾血管疾病，经典方法能识别其中8.6 - 9.1种，静脉动脉造影和肾盂造影联合检查能识别10.4 - 10.9种，以此衡量诊断有效性。对于100例高血压患者中存在的2 - 3例肾血管性高血压，经典方法能识别其中1.8 - 1.9例，静脉动脉造影和肾盂造影联合检查能识别2.1 - 2.27例，以此衡量诊断有效性。根据拍摄片子数量，常规静脉动脉造影找到可治愈的肾血管性高血压患者的费用分别为51543法郎和53264法郎；对于经典方法，根据Seldinger动脉造影的适应症是纯粹基于尿路造影还是也有临床依据，费用分别为65738法郎和86815法郎。总之，与基于尿路造影和临床数据选择Seldinger动脉造影的经典方法相比，静脉肾动脉造影和尿路造影联合检查是一种诊断肾血管疾病和高血压更可靠且成本更低的方法。此外，这种技术可预防动脉插管并发症，并允许对可能威胁肾脏生命的未手术狭窄以及已手术或扩张的狭窄进行无创随访。
