Résumé
The aim of the study was to evaluate the anatomic results of percutaneous transluminal renal angioplasty in a population of 113 hypertensive patients (66 men, mean age 63 years) who had a significant renal artery stenosis (atheromatous in 105 patients and fibrodysplastic in the eight others). Conventional angioplasty was performed in 89 arteries, and stent implantation in 46 cases. Stenting was associated with a better immediate result than simple angioplasty for atheromatous stenoses (rate of residual stenosis < 30% = 93.5% and 71.2% respectively, p < 0.003). Technical success for angioplasty of atheromatous stenoses was achieved in 73.8% of procedures involving non ostial lesions and 51.6% for ostial stenoses (p = 0.05). Restenosis was detected 6.3 +/- 0.3 months later (by echodoppler and/or helical computed tomography angiography) in 9.1% of cases after stent implantation and in 47% after simple angioplasty (p = 0.00017). The presence of a residual stenosis < 30% immediately after revascularization was associated with a significantly (26.4% versus 50%, p = 0.044) lower rate of restenosis. In conclusion, this study confirms the utility of percutaneous transluminal renal angioplasty for treatment of renovascular hypertension, particularly with the utilisation of stents for atheromatous and ostial stenoses.The aim of the study was to evaluate the anatomic results of percutaneous transluminal renal angioplasty in a population of 113 hypertensive patients (66 men, mean age 63 years) who had a significant renal artery stenosis (atheromatous in 105 patients and fibrodysplastic in the eight others). Conventional angioplasty was performed in 89 arteries, and stent implantation in 46 cases. Stenting was associated with a better immediate result than simple angioplasty for atheromatous stenoses (rate of residual stenosis < 30% = 93.5% and 71.2% respectively, p < 0.003). Technical success for angioplasty of atheromatous stenoses was achieved in 73.8% of procedures involving non ostial lesions and 51.6% for ostial stenoses (p = 0.05). Restenosis was detected 6.3 +/- 0.3 months later (by echodoppler and/or helical computed tomography angiography) in 9.1% of cases after stent implantation and in 47% after simple angioplasty (p = 0.00017). The presence of a residual stenosis < 30% immediately after revascularization was associated with a significantly (26.4% versus 50%, p = 0.044) lower rate of restenosis. In conclusion, this study confirms the utility of percutaneous transluminal renal angioplasty for treatment of renovascular hypertension, particularly with the utilisation of stents for atheromatous and ostial stenoses.