Stenoses of renal branch arteries in fibromuscular dysplasia: results of percutaneous transluminal angioplasty

Abstract

Purpose: To evaluate percutaneous transluminal renal angioplasty (PTRA) in the treatment of renal branch artery stenoses caused by fibromuscular dysplasia.

Materials and methods: The authors retrospectively studied the files of 20 consecutive hypertensive patients with 25 branch artery stenoses associated with 10 main renal artery lesions. Results at clinical and angiographic follow-up were assessed by means of life-table analysis.

Results: PTRA was technically successful in 21 of the 25 renal branch artery stenoses (84%). One of the technical failures was treated by means of selective embolization. Nine of the 10 associated main renal artery lesions were successfully dilated, and the 10th was improved. Immediately after PTRA, at 6-month follow-up, and at long-term follow-up, 70%, 76%, and 68% of the patients, respectively, were cured and 25%, 24%, and 16% were improved. Stenosis recurred in 9% of the branch arteries and was associated with clinical relapse; these arteries were redilated, and all patients were considered cured at the second 6-month follow-up.

Conclusion: PTRA should be considered the first-line treatment for hypertension due to renal branch artery stenosis in fibromuscular disease.