Percutaneous Transluminal Angioplasty in the Management of Renovascular Hypertension

  • D. M. Tillman
  • F. G. Adams
Part of the New Clinical Applications Nephrology book series (NCNG)


Renovascular hypertension, which probably accounts for between 1% and 2% of an unselected hypertensive population1, not only constitutes the dual threat of severe hypertension with its complications and progressive renal insufficiency, but may also be a marker of widespread vascular disease. Until recently, the therapeutic options were limited to medical treatment with antihypertensive drugs, reconstructive surgery, or nephrectomy. Conventional drug therapy often proves inadequate for the optimal control of hypertension associated with renovascular disease, while polypharmacy and unwanted side-effects contribute to poor patient compliance. The introduction of angiotensin converting enzyme inhibitors provided a means of effectively controlling hypertension in most patients with renal artery stenosis2,3. Successful medical therapy, however, was associated in some instances with a decrease in renal function4,5, and patients with bilateral renal artery stenoses or severe stenosis in a solitary functioning kidney ran the risk of developing acute oliguric renal failure6,7.


Renal Artery Renal Artery Stenosis Renovascular Hypertension Fibromuscular Dysplasia Renovascular Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Genest, J., Cartier, P., Roy, P., Lefebvre, R., Kuchel, O., Cantin, M. and Hammet, P. (1983). Renovascular hypertension. In Genest, J., Kuchel, O., Hammet, P., Cantin, M. (Eds.) Hypertension, pp. 1007–1034 (New York: McGraw-Hill)Google Scholar
  2. 2.
    Hodsman, G.P., Brown, J.J., Cumming, A.M.M., Davies, D.L., East, B.W., Lever, A.F., Morton, J.J., Murray, G.D. and Robertson, J.I.S. (1984). Enalapril in treatment of hypertension with renal artery stenosis: changes in blood pressure, renin, angiotensin I and II, renal function and body composition. Am. J. Med., 77 (Suppl. 2A), 52–60PubMedGoogle Scholar
  3. 3.
    Hodsman, G.P. and Robertson, J.I.S. (1983). Captopril: Five years on. Br. Med. 287, 2–2CrossRefGoogle Scholar
  4. 4.
    Tillman, D.M., Malatino, L.S., Cumming, A.M.M., Hodsman, G.P., Leckie, B.J., Lever, A.F., Morton, J.J., Webb, D.J. and Robertson, J.I.S. (1984). Enalapril in hypertension with renal artery stenosis: long-term follow-up and effects on renal function. J. Hypertension, 2, (Suppl. 2) 93–100Google Scholar
  5. 5.
    Sos, T.A., Saddekni, S., Pickering, T.G. and Laragh, J.H. (1986). Technical aspects of percutaneous transluminal angioplasty in renovascular disease. Nephron., 44 (Suppl. 1), 45–50PubMedCrossRefGoogle Scholar
  6. 6.
    Hricik, D.E., Browning, P.J., Kopelman, R., Goorno, W.E., Madias, N.E. and Dzau, V.J. (1983). Captopril-induced functional renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney. N. Engl. J. Med., 308, 373–6PubMedCrossRefGoogle Scholar
  7. 7.
    Blythe, W.B. (1983). Captopril and renal autoregulation. N. Engl. J. Med. 308, 390–1PubMedCrossRefGoogle Scholar
  8. 8.
    Foster, J.H., Maxwell, M.H., Franklin, S.S., Bleifer, K.H., Trippel, O.H., Julian, O.C., de Camp, P.T. and Varady, P.D. (1975). Renovascular occlusive disease: results of operative treatment. J. Am. Med. Assoc., 231, 1043–8CrossRefGoogle Scholar
  9. 9.
    Franklin, S.S., Young, J.D., Maxwell, M.H., Foster, J.H., Palmer, J.M., Cerny, J. and Varaday, P.D. (1975). Operative morbidity and mortality in renovascular disease. J. Am. Med. Assoc., 231, 1148–53CrossRefGoogle Scholar
  10. 10.
    MacKay A., Boyle, P., Brown, J.J., Cumming, A.M.M., Forrest, H., Graham, A.G., Lever, A.F., Robertson, J.I.S. and Semple, P.F. (1983). The decision on surgery in renal artery stenosis. Q. J. Med. 207, 363–81Google Scholar
  11. 11.
    Sellars, L., Siamopoulos, K., Hacking, P.M., Proud, G., Taylor, R.M.R., Essenhigh, D.M. and Wilkinson, R. (1985). Renovascular hypertension: Ten years’ experience in a regional centre. Q. J. Med., 219, 403–16Google Scholar
  12. 12.
    Sellars, L., Shore, A.C. and Wilkinson, R. (1985). Renal vein renin studies in renovascular hypertension—Do they really help? J. Hypertension, 3, 177–81CrossRefGoogle Scholar
  13. 13.
    Gruntzig, A., Kuhlmann, U., Vetter, W., Lutolf, V., Meier, B. and Siegenthaler, W. (1978). Treatment of renovascular hypertension with percutaneous transluminal dilatation of a renal artery stenosis. Lancet, 1, 2–2PubMedCrossRefGoogle Scholar
  14. 14.
    Geyskes, G.G., Puylaert, C.B.A.J., Oei, H.Y. and Mees, E.J.D. (1983). Follow-up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation. Br. Med. J., 287, 333–6CrossRefGoogle Scholar
  15. 15.
    Colapinto, R.F., Stronell, R.D., Harries-Jones, E.P., Gildiner, M., Hobbs, B.B., Farrow, G.A., Wilson, D.R., Morrow, J.D., Logan, A G. and Birch, S.J. (1982). Percutaneous transluminal dilatation of the renal artery: follow-up studies on renovascular hypertension. Am. J. Roentgenol., 139, 727–32CrossRefGoogle Scholar
  16. 16.
    Sos, T.A., Pickering, T.G., Sniderman, K., Saddekni, S., Case, D.B., Silane, M.F., Vaughan, E.D. and Laragh, J.H. (1983). Percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma or fibromuscular dysplasia. N. Engl. J. Med., 309, 274–9PubMedCrossRefGoogle Scholar
  17. 17.
    Martin, E.C., Mattern, R.F., Baer, L., Fankuchen, E.I. and Casarella, W.J. (1981). Renal angioplasty for hypertension: predictive factors for long-term success. Am. J. Roentgenol, 137, 921–4CrossRefGoogle Scholar
  18. 18.
    Tegtmeyer, C.J., Kofler, T.J. and Ayers, C.A. (1984). Renal angioplasty: current status. Am. J. Roentgenol., 142, 17–21CrossRefGoogle Scholar
  19. 19.
    Atkinson, A.B. and Kellett, R.J. (1974). Value of intravenous urography in investigating hypertension. J. R. Coll. Physicians. London, 8 (Suppl. 2), 175–81Google Scholar
  20. 20.
    MacKay, A., Brown, J.J., Lever, A.F., Morton, J.J. and Robertson, J.I.S. (1983). Unilateral renal disease in hypertension. In Robertson J.I.S. (Ed.) Handbook of Hypertension, Vol. 2, Clinical Aspects of Secondary Hypertension, pp. 33–97 (Amsterdam: Elsevier)Google Scholar
  21. 21.
    Bookstein, J.J., Abrams, H.L., Buenger, R.E., Lecky, J., Franklin, S.S., Reiss, M.D., Bleifer, K.H., Klatte, E.C., Varaday, P.D. and Maxwell, M.H. (1972). Radiologic aspects of renovascular hypertension. II. The role of urography in unilateral renovascular disease. J. Am. Med. Assoc., 220, 1225–30CrossRefGoogle Scholar
  22. 22.
    Harvey, R.J., Krumlovsky, F., del Greco, F. and Martin H.G. (1985). Is renal digital subtraction angiography the preferred non invasive test? J. Am. Med. Assoc., 254, 388–93CrossRefGoogle Scholar
  23. 23.
    Maxwell, M.H., Lupu, A.N. and Taplin, G.V. (1968). Radioisotope renogram in renal arterial hypertension. Urol., 100, 376–83Google Scholar
  24. 24.
    MacKay, A., Eadie, A.S., Cumming, A.M.M., Graham, A.G., Adams, F.G. and Horton, P.W. (1981). Assessment of total and divided renal plasma flow by 123I-hippuran renography. Kidney Int., 19, 49–57PubMedCrossRefGoogle Scholar
  25. 25.
    Bratt, C.G., Larsson, I. and White, I. (1981). Scintillation camera renography with 99M Tc-DTPA and 131I-hippuran. Scand. J. Clin. Lab. Invest., 41, 189–97PubMedCrossRefGoogle Scholar
  26. 26.
    Pors Nielsen, S., Lehd Moller M. and Trap-Jensen, J. (1977). 99M Tc-DTPA scintillation camera renography: a new method for estimation of single kidney function. J. Nucl. Med., 18, 112–17Google Scholar
  27. 27.
    Wenting, G.J., Tan-Tjiong, H., Derkx, F.H.M., De Bruyn, J.H.B., Man Int Veld, A.J. and Schalekamp, M.A.D.H. (1984). Split renal function after Captopril in unilateral renal artery stenosis. Br. J. Med., 288, 886–90CrossRefGoogle Scholar
  28. 28.
    Geyskes, G.G., Oei, H.Y. and Faber, J.A.J. (1986). Renography: prediction of blood pressure after dilatation of renal artery stenosis. Nephron, 44 (Suppl. 1), 54–9PubMedCrossRefGoogle Scholar
  29. 29.
    Sfakianakis, G.N., Bourgoignie, J.J. and Jaffe, D. (1987). The effect of Captopril on renography in renovascular hypertension (RVH): a predictor of response to angioplasty (Abstract). J. Nucl. Med., 28 (Suppl.), 613Google Scholar
  30. 30.
    Fommei, E., Ghione, S., Palla, L., Bertelli, P., Marabotti, C. and Palombo, C. (1987). The scintigraphic Captopril test in renovascular hypertension (Abstract). J. Nucl. Med., 28 (Suppl.), 613Google Scholar
  31. 31.
    Phillips, D.J., Powers, J.E., Eyers, M.K., Blackshear, W.M., Bodily, K.C., Strandness, D.E. and Baker, D.W. (1980). Detection of peripheral vascular disease using the duplex scanner III. Ultrasound Med. Biol., 6, 205–18PubMedCrossRefGoogle Scholar
  32. 32.
    Blackshear, W.M., Phillips, D.J., Chikos, P.M., Hartley, J.D., Thiele, B.L. and Strandness, D.E. (1980). Carotid artery velocity patterns in normal and stenotic vessels. Stroke, 11, 67–71PubMedCrossRefGoogle Scholar
  33. 33.
    Avasthi, P.S., Voyles, W.F. and Greene, E.R. (1984). Noninvasive diagnosis of renal artery stenosis by echo-Doppler velocimetry. Kidney Int., 25, 824–9PubMedCrossRefGoogle Scholar
  34. 34.
    Jenni, R., Vieli, A., Luscher, Th. F., Schneider, E., Vetter, W. and Anliker, M. (1986). Combined two-dimensional ultrasound Doppler technique. New possibilities for the screening of renovascular and parenchymatous hypertension. Nephron., 44 (Suppl. 1), 2–4PubMedCrossRefGoogle Scholar
  35. 35.
    Hillman, B.J., Ovitt, T.W., Nudelman, S., Fisher, H.D., Frost, M.M., Capp, M.P., Roehrig, H. and Seely, G. (1981). Digital video subtraction angiography of renal vascular abnormalities. Radiology, 139, 277–80PubMedGoogle Scholar
  36. 36.
    Osborne, R.W. Jnr., Goldstone, J., Hillman, B.J., Ovitt, T.W., Malone, J.M. and Nudelman, S. (1981). Digital video subtraction angiography: screening technique for renovascular hypertension. Surgery., 90, 932–9PubMedGoogle Scholar
  37. 37.
    Vaughan, E.D. (1985). Renovascular hypertension. Nephrology Forum. Kidney Int., 27, 811–27PubMedCrossRefGoogle Scholar
  38. 38.
    Eyler, W.R., Clark, M.D., Garman, J.E., Rian, R.L. and Meininger, D.E. (1962). Angiography of the renal areas including a comparative study of renal arterial stenosis in patients with and without hypertension. Radiology, 78, 879–92PubMedGoogle Scholar
  39. 39.
    Holley, K.E., Hunt, J.C., Brown, A.L., Kincaid, O.W. and Sheps, S.G. (1964). Renal artery stenosis: a clinical-pathologic study in normotensive patients. Am. J. Med., 37, 2–22PubMedCrossRefGoogle Scholar
  40. 40.
    Brown, J.J., Cuesta, V., Davies, D.L., Lever, A.F., Morton, J.J., Padfield, P.L., Robertson, J.I.S., Trust, P., Bianchi, G. and Schalekamp, M.A.D.H. (1976). Mechanisms of renal hypertension. Lancet, 1, 2–21PubMedCrossRefGoogle Scholar
  41. 41.
    Luscher, T.F., Greminger, P., Kuhlmann, U., Siegenthaler, W., Largiader, F. and Vetter, W. (1986). Renal venous renin determinations in renovascular hypertension: diagnostic and prognostic value in unilateral renal artery stenosis treated by surgery or percutaneous transluminal angioplasty. Nephron., 44 (Suppl. 1), 17–24PubMedCrossRefGoogle Scholar
  42. 42.
    Maxwell, M.H. (1981). Diagnosis of renovascular hypertension. In Zurukzoglu, W., Pamidimitriou, M., Pyrapasopoulos, Y., Sion, M. and Zamboulins, C. (Eds.) Proceedings of the 8th International Congress of Nephrology, pp. 1119–24. Basel: KargerGoogle Scholar
  43. 43.
    Miller, G.A., Ford, K.K., Braun, S.D., Newman, G.E., Moore, A.V., Jr., Malone, R. and Dunnick, N.R. (1985). Percutaneous transluminal angioplasty vs surgery for renovascular hypertension. Am. J. Roentgenol., ., 144, 447–50CrossRefGoogle Scholar
  44. 44.
    Judson, W.E. and Helmer, O.M. (1965). Diagnostic and prognostic values of renin activity in renal venous plasma in renovascular hypertension. Hypertension., 13, 79–89Google Scholar
  45. 45.
    Brown, J.J., Lever, A.F. and Robertson, J.I.S. (1979). Renal hypertension: aetiology, diagnosis and treatment. In Black Sir D, Jones, N.F. (Eds.) Renal Disease, 4th Edn, p. 731, Oxford, BlackwellGoogle Scholar
  46. 46.
    Michelakis, A.M. and Simmons, J. (1969). Effects of posture on renal vein renin activity in hypertension: its implications in the management of patients with renovascular hypertension. J. Am. Med. Assoc., 208, 659–62CrossRefGoogle Scholar
  47. 47.
    Strong, C.G., Hunt, J.C., Sheps, S.G., Tucker, R.M. and Bernatz, P.E. (1971). Renal venous renin activity: enhancement of sensitivity of lateralisation by sodium depletion. Am. J. Cardiol., 27, 602–11PubMedCrossRefGoogle Scholar
  48. 48.
    Mannick, J.A., Huvos, A. and Hollander, W.E. (1969). Post-hydralazine renin release in the diagnosis of renovascular hypertension. Ann. Surg., 170, 409–15PubMedCrossRefGoogle Scholar
  49. 49.
    Lyons, D.F., Streck, W.F., Kern, D.C., Brown, R.D., Galloway, D.C., Williams, G.R., Chrysant, S.G., Danisa, K. and Carollo, M. (1983). Captopril stimulation of differential renins in renovascular hypertension. Hypertension, 5, 615–22PubMedCrossRefGoogle Scholar
  50. 50.
    Marks, L.S. and Maxwell, M.H. (1975). Renal vein renin: value and limitations in the prediction of operative results. Urol. Clin. N. Am., 2, 311–25Google Scholar
  51. 51.
    Kuhlmann, U., Greminger, P., Gruntzig, A., Schneider, E., Pouliadis, G., Luscher, T., Steurer, J., Siegenthaler, W. and Vetter, W. (1985). Long term experience in percutaneous transluminal dilatation of renal artery stenosis. Am. J. Med., 79, 692–8PubMedCrossRefGoogle Scholar
  52. 52.
    Stockigt, J.R., Collins, R.D., Noakes, C.A., Schambelan, M. and Biglieri, E.G. (1972). Renal vein renin in various forms of renal hypertension. Lancet, 1, 1194–8PubMedCrossRefGoogle Scholar
  53. 53.
    Vaughan, E.D., Buhler, F.R., Laragh, J.H., Sealey, J.E., Baer, L. and Bard, R.H. (1973). Renovascular hypertension: renin measurements to indicate hypersecretion and contralateral suppression, estimate renal plasma flow, and score for surgical curability. Am. J. Med., 55, 402–14PubMedCrossRefGoogle Scholar
  54. 54.
    Pickering, T.G., Sos, T.A., Vaughan, E.D., Case, D.B., Sealey, J.E., Harshfield, G.A. and Laragh, J.H. (1984). Predictive value and changes of renin secretion in hypertensive patients with unilateral renovascular disease undergoing successful renal angioplasty. Am. J. Med., 76, 398–404PubMedCrossRefGoogle Scholar
  55. 55.
    Pickering, T.G., Sos, T.A., Vaughan, E.D. and Laragh, J.H. (1986). Differing patterns of renal vein renin secretion in patients with renovascular hypertension, and their role in predicting the response to angioplasty. Nephron, 44 (Suppl. 1), 8–11 PubMedCrossRefGoogle Scholar
  56. 56.
    Brunner, H.R., Gavras, H., Laragh, J.H. and Keenan, R. (1973). Angiotensin-II blockade in man by Sar1-Ala8-angiotensin II for understanding and treatment of high blood pressure. Lancet, 2, 1045–8PubMedCrossRefGoogle Scholar
  57. 57.
    Streeten, D.H.P., Anderson, G.H., Freiberg, J.M. and Dalakos, T.G. (1975). Use of an angiotensin II antagonist (Saralasin) in the recognition of ’angiotensinogenic’ hypertension. N. Engl. J. Med., 292, 657–62PubMedCrossRefGoogle Scholar
  58. 58.
    Krakoff, L.R., Ribeiro, A.B., Gorkin, J.U. and Felton, K.R. (1980). Saralasin infusion in screening patients for renovascular hypertension. Am. J. Cardiol., 45, 609–13PubMedCrossRefGoogle Scholar
  59. 59.
    Atkinson, A.B., Brown, J.J., Cumming, A.M.M., Fraser, R., Lever, A.F., Leckie, B.J., Morton, J.J. and Robertson, J.I.S. (1982). Captopril in the management of hypertension with renal artery stenosis: its long-term effect as a predictor of surgical outcome. Am. J. Cardiol., 49, 1460–6PubMedCrossRefGoogle Scholar
  60. 60.
    Staessen, J., Bulpitt, C., Fagard, R., Lijnen, P. and Amery, A. (1983). Long-term converting-enzyme inhibitor as a guide to surgical curability of hypertension associated with renovascular disease. Am. J. Cardiol., 51, 1317–22PubMedCrossRefGoogle Scholar
  61. 61.
    Vaughan, E.D., Case, D.B., Pickering, T.G., Sosa, R.E., Sos, T.A. and Laragh, J.H. (1984). Clinical evaluation of renovascular hypertension and therapeutic decisions. Urol. Clin. N. Am., 11, 393–407Google Scholar
  62. 62.
    Grim, C.E., Yune, H.Y., Donohue, J.P., Weinberger, M.H., Dilley, R. and Klatte, E.C. (1986). Renal vascular hypertension: surgery vs. dilatation. Nephron, 44 (Suppl. 1), 96–100PubMedCrossRefGoogle Scholar
  63. 63.
    Dotter, C.T. and Judkins, M.P. (1964). Transluminal treatment of arteriosclerotic obstruction: description of a new technic and a preliminary report of its application. Circulation, 30, 654–70PubMedCrossRefGoogle Scholar
  64. 64.
    Gruntzig, A. and Hopff, H. (1974). Perkutane rekanalisation chronischer arterieller Verschlusse mit einem neuen Dilatationskatheter. Modifikation der Dotter-Technik. Dtsch. Med. Wochenschr., 99, 2502–5PubMedCrossRefGoogle Scholar
  65. 65.
    Schwarten, D.E. (1980). Transluminal angioplasty of renal artery stenosis: 70 experiences. Am. J. Roentgenol., 135, 969–74CrossRefGoogle Scholar
  66. 66.
    Tegtmeyer, C.J., Ayers, C.A. and Wellons, H.A. (1980). The axillary approach to percutaneous renal artery dilatation. Radiology, 135, 775–6PubMedGoogle Scholar
  67. 67.
    Castaneda-Zuniga, W.R., Formanek, A., Tadavarthy, M., Vlodaver, Z., Edwards, J.E., Zollikofer, C. and Amplatz, K. (1980). The mechanism of balloon angioplasty. Radiology, 135, 565–71PubMedGoogle Scholar
  68. 68.
    Wolf, G.L., Le Veen, R.F. and Ring, E.J. (1984). Potential mechanisms of angioplasty. Cardiovasc. Intervent. Radiol., 7, 11–17PubMedCrossRefGoogle Scholar
  69. 69.
    Circuto, K.P., McLean, G.K., Oleaga, J.A., Freiman, D.B., Grossman, R.A. and Ring, E.J. (1981). Renal artery stenosis: anatomic classification for percutaneous angioplasty. Am. J. Roentgenol., 137, 599–601CrossRefGoogle Scholar
  70. 70.
    Flechner, S.M. (1984). Percutaneous transluminal dilatation: a realistic appraisal in patients with stenosing lesions of the renal artery. Urol. Clin. N. Am., 11, 515–27Google Scholar
  71. 71.
    Sniderman, K.W. and Sos, T.A. (1982). Percutaneous transluminal recanalisation and dilatation of totally occluded renal arteries. Radiology, 142, 607–10PubMedGoogle Scholar
  72. 72.
    Mahler, F., Triller, J., Weidmann, P. and Nachbur, B. (1986). Complications in percutaneous transluminal dilatation of renal arteries. Nephron, 44 (Suppl. 1), 60–3PubMedCrossRefGoogle Scholar
  73. 73.
    Madias, N.E., Ball, J.T. and Millan, V.G. (1981). Percutaneous transluminal renal angioplasty in the treatment of unilateral atherosclerotic renovascular hypertension. Am. J. Med., 70, 1078–84PubMedCrossRefGoogle Scholar
  74. 74.
    Millan, V.G., McCauley, J., Kopelman, R.I. and Madias, N.E. (1985). Percutaneous transluminal renal angioplasty in nonatherosclerotic renovascular hypertension: long-term results. Hypertension, 7, 668–74PubMedCrossRefGoogle Scholar
  75. 75.
    Grim, C.E., Luft, F.C., Yune, H.Y., Klatte, E.C. and Weinberger, M.H. (1981). Percutaneous transluminal dilatation in the treatment of renal vascular hypertension. Ann. Intern. Med., 95, 439–42PubMedGoogle Scholar
  76. 76.
    Kremer Hovinga, T.K., de Jong, P.E., de Zeeuw, D., Donker, A.J.M., Schuur, K.H. and van der Hem, G.K. (1986). Restenosis prevalence and long-term effects on renal function after percutaneous transluminal renal angioplasty. Nephron, 44 (Suppl. 1), 64–7PubMedCrossRefGoogle Scholar
  77. 77.
    Tegtmeyer, C.J., Kellum, C.D. and Ayers, C. (1984). Percutaneous transluminal angioplasty of the renal artery: results and long-term follow-up. Radiology, 153, 77–84PubMedGoogle Scholar
  78. 78.
    de Jong, P.E., de Zeeuw, D., Smit, A.J., Hoorntjest, S.J., Schuur, K.H., Donker, A.J. and Van der Hem, G.K. (1983). The effect of transluminal dilatation of stenosed renal arteries on kidney function. Neth. J. Med., 26, 266–70PubMedGoogle Scholar
  79. 79.
    Maxwell, M.H., Bleifer, K.H., Franklin, S.S. and Varaday, P.D. (1972). Cooperative study of renovascular hypertension: demographic analysis of the study. J. Am. Med. Assoc., 220, 1195–2004CrossRefGoogle Scholar
  80. 80.
    Meaney, T.F., Dustan, H.P. and McCormack, L.J. (1968). Natural history of renal arterial disease. Radiology, 9, 877–87Google Scholar
  81. 81.
    Wollenweber, J., Sheps, S.G. and David, D.G. (1968). Clinical course of atherosclerotic renovascular disease. Am. J. Cardiol., 21, 60–71PubMedCrossRefGoogle Scholar
  82. 82.
    Schreiber, M.J., Pohl, M.A. and Novick, A.C. (1984). The natural history of atherosclerotic and fibrous renal artery disease. Urol. Clin. North. Am., 11, 383–92PubMedGoogle Scholar
  83. 83.
    Pickering, T.G., Sos, T.A., Saddekni, S., Rozenblit, G., James, G.D., Orenstein, A., Heiseth, G. and Laragh, J.H. (1986). Renal angioplasty in patients with azotaemia and renovascular hypertension. J. Hypertension, 4 (Suppl. 6), S667–9Google Scholar
  84. 84.
    Weinberger, M.H., Grim, C.E., Luft, F.C. and Yune, H.Y. (1986). Percutaneous transluminal angioplasty in complicated renal vascular hypertension. Nephron, 44 (Suppl. 1), 51–3PubMedCrossRefGoogle Scholar
  85. 85.
    Lacombe, M. (1975). Arterial stenosis complicating renal allotransplantation in man: a study of thirty-eight cases. Ann. Surg., 181, 283–8PubMedCrossRefGoogle Scholar
  86. 86.
    Sagalogsky, A.I. and Peters, P.C. (1984). Renovascular hypertension following renal transplantation. Urol. Clin. North Am. s., 11, 491–502Google Scholar
  87. 87.
    Whelton, P.K., Russell, R.P., Harrington, D.P., Williams, G.M. and Walker, W.G. (1979). Hypertension following renal transplantation: causative factors and therapeutic implications. J. Am. Med. Assoc., 241, 1128–31CrossRefGoogle Scholar
  88. 88.
    Flechner, S.M., Sandler, C.M., Childs, T., Ben-Menachem, Y., Van Buren, C., Payne, W. and Kahan, B.D. (1983). Screening for transplant renal artery stenosis in hypertensive recipients using digital subtraction angiography. J. Urol., 130, 440–4PubMedGoogle Scholar
  89. 89.
    Smith, R.B. and Elrich, R.M. (1976). The surgical complications of renal transplantation. Urol. Clin. North. Am., 3, 621–46PubMedGoogle Scholar
  90. Smith, R.B. Arterial stenosis in renal transplantation. In Kaufmann, J.J. (Ed.) Current Urologie Therapy, pp. 151–153. (Philadelphia: W.B. Saunders)Google Scholar
  91. 91.
    Buist, T.A. (1985). Percutaneous renal angioplasty. J. R. Soc. Med., 78, 353–5PubMedGoogle Scholar
  92. 92.
    Sniderman, K.W., Sos, T.A., Sprayregan, S., Saddekni, S., Cheigh, J.S., Tapia, L., Tellis, V. and Veith, F. (1980). Percutaneous transluminal angioplasty in renal transplant arterial stenosis for relief of hypertension. Radiology, 135, 23–6PubMedGoogle Scholar
  93. 93.
    Mollenkopf, F., Matas, A., Veith, F., Sprayregan, S., Soberman, R., Kuemmel, P., Tellis, V., Sniderman, K.W., Sos, T.A., Cheigh, J.S. and Stubenbord, W. (1983). Percutaneous transluminal angioplasty for transplant renal artery stenosis. Transplant. Proc., 15, 1089–91Google Scholar
  94. 94.
    Dafoe, D.C., Schoenfeld, R.B. and Grossman, R.A. (1982). Percutaneous transluminal angioplasty treatment of renal allograft artery stenosis. Presented at the 8th Annual Meeting of the American Society of Transplant Surgeons, Chicago, Illinois, June 3–4Google Scholar
  95. 95.
    Majeski, J.A. and Munda, R. (1981). Hazard of percutaneous transluminal dilatation in renal transplant arterial stenosis. Arch. Surg., 116, 1225–6PubMedCrossRefGoogle Scholar
  96. 96.
    Medina, M., Butt, K., Gordon, D.H., Thanawala, S. and Solomon, N. (1981). A complication of percutaneous transluminal angioplasty in the transplanted kidney. Urol. Radiol., 3, 59PubMedCrossRefGoogle Scholar
  97. 97.
    Rientgen, D., Van Moore, A., Vernon, W. et al. (1983). Percutaneous renal artery angioplasty for transplant renal artery stenosis. Proc. Am. Soc. Transplant Surg., Chicago, IllinoisGoogle Scholar
  98. 98.
    Millar, J.A., Leckie, B.J., Semple, P.F., Morton, J.J., Sonkodi, S. and Robertson, J.I.S. (1978). Active and inactive renin in human plasma: renal arteriovenous differences and relationships with angiotensin and renin substrate. Circ. Res., 43 (Suppl. 1), 120–7Google Scholar
  99. 99.
    Mahler, F., Probst, P., Haertel, M., Weidmann, P. and Krneta, A. (1982). Lasting improvement of renovascular hypertension by transluminal dilatation of atherosclerotic and nonatherosclerotic renal artery stenosis: a follow-up study. Circulation, 65, 611–17PubMedCrossRefGoogle Scholar
  100. 100.
    Bell, G.M., Reid, J. and Buist, T.A.S. (1987). Percutaneous transluminal angioplasty improves blood pressure and renal function in renovascular hypertension. Q. J. Med., 241, 393–403Google Scholar

Copyright information

© MTP Press Limited 1988

Authors and Affiliations

  • D. M. Tillman
  • F. G. Adams

There are no affiliations available

Personalised recommendations