Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis
(2005) In Journal of Human Hypertension 19(10). p.761-767- Abstract
- Fibromuscular dysplasia (FMD) mainly affects renal arteries. Percutaneous transluminal renal angioplasty (PTRA) and surgery are effective treatments, but longtime follow-up is lacking. Retrospective follow-up for 7.0 +/- 4.7 years of 69 consecutive patients ( age 44 +/- 13 years) treated for hypertension due to FMD, 59 patients underwent PTRA and eight patients surgery. In two patients no PTRA was performed. Technical success was achieved in 56 (95%) patients undergoing PTRA and all eight undergoing surgery. After successful PTRA, both systolic and diastolic blood pressures (SBP and DBP) had decreased at discharge ( from 174 +/- 33/ 100 +/- 13 to 138 +/- 19/80 +/- 15 mmHg; P<0.0001), and remained lower at 1 month, 1 year, and last... (More)
- Fibromuscular dysplasia (FMD) mainly affects renal arteries. Percutaneous transluminal renal angioplasty (PTRA) and surgery are effective treatments, but longtime follow-up is lacking. Retrospective follow-up for 7.0 +/- 4.7 years of 69 consecutive patients ( age 44 +/- 13 years) treated for hypertension due to FMD, 59 patients underwent PTRA and eight patients surgery. In two patients no PTRA was performed. Technical success was achieved in 56 (95%) patients undergoing PTRA and all eight undergoing surgery. After successful PTRA, both systolic and diastolic blood pressures (SBP and DBP) had decreased at discharge ( from 174 +/- 33/ 100 +/- 13 to 138 +/- 19/80 +/- 15 mmHg; P<0.0001), and remained lower at 1 month, 1 year, and last follow-up after 7.0 +/- 4.7 years (140 +/- 25/83 +/- 12 mmHg; P<0.0001). Serum-creatinine had decreased both at 1 year ( from 84 +/- 28 to 75 +/- 13 mu mol/ l; P = 0.0030) and last follow-up (75 +/- 16 mu mol/ l; P = 0.0017). The number of antihypertensive drugs decreased ( from 2.3 +/- 1.2 before PTRA to 1.4 +/- 1.3 at discharge and at 1 month; P<0.0001, and 1.6 +/- 1.5 at last follow-up; P = 0.0011). SBP decreased more after PTRA among patients with FMD only in the main renal artery than in those with branch artery involvement (43 +/- 29 vs 20 +/- 41 mmHg; P = 0.0198). Beneficial effects on BP, creatinine and antihypertensive drugs also occurred after surgery. Patients on antihypertensive drugs at last follow-up had longer hypertension duration before PTRA than those without (5.9 +/- 7.7 vs 1.8 +/- 4.1 years; P = 0.0349). Cure was achieved in 16 (24%), improvement in another 26(39%), and benefit in 42(63%). In conclusion, renal artery FMD, PTRA and surgery have beneficial long-term effects, negatively affected by hypertension duration and branch artery involvement. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/223716
- author
- Alhadad, Alaa LU ; Mattiasson, Ingrid LU ; Ivancev, Krassi LU ; Gottsäter, Anders LU and Lindblad, Bengt LU
- organization
- publishing date
- 2005
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- surgical reconstruction, PTRA, fibromuscular dysplasia, renal artery, long-term follow-up
- in
- Journal of Human Hypertension
- volume
- 19
- issue
- 10
- pages
- 761 - 767
- publisher
- Nature Publishing Group
- external identifiers
-
- wos:000232027300003
- pmid:15920452
- scopus:27144549290
- ISSN
- 1476-5527
- DOI
- 10.1038/sj.jhh.1001893
- language
- English
- LU publication?
- yes
- id
- 0376064f-92e0-4d65-b624-8a6c84f925a6 (old id 223716)
- date added to LUP
- 2016-04-01 11:52:22
- date last changed
- 2022-04-13 02:35:33
@article{0376064f-92e0-4d65-b624-8a6c84f925a6, abstract = {{Fibromuscular dysplasia (FMD) mainly affects renal arteries. Percutaneous transluminal renal angioplasty (PTRA) and surgery are effective treatments, but longtime follow-up is lacking. Retrospective follow-up for 7.0 +/- 4.7 years of 69 consecutive patients ( age 44 +/- 13 years) treated for hypertension due to FMD, 59 patients underwent PTRA and eight patients surgery. In two patients no PTRA was performed. Technical success was achieved in 56 (95%) patients undergoing PTRA and all eight undergoing surgery. After successful PTRA, both systolic and diastolic blood pressures (SBP and DBP) had decreased at discharge ( from 174 +/- 33/ 100 +/- 13 to 138 +/- 19/80 +/- 15 mmHg; P<0.0001), and remained lower at 1 month, 1 year, and last follow-up after 7.0 +/- 4.7 years (140 +/- 25/83 +/- 12 mmHg; P<0.0001). Serum-creatinine had decreased both at 1 year ( from 84 +/- 28 to 75 +/- 13 mu mol/ l; P = 0.0030) and last follow-up (75 +/- 16 mu mol/ l; P = 0.0017). The number of antihypertensive drugs decreased ( from 2.3 +/- 1.2 before PTRA to 1.4 +/- 1.3 at discharge and at 1 month; P<0.0001, and 1.6 +/- 1.5 at last follow-up; P = 0.0011). SBP decreased more after PTRA among patients with FMD only in the main renal artery than in those with branch artery involvement (43 +/- 29 vs 20 +/- 41 mmHg; P = 0.0198). Beneficial effects on BP, creatinine and antihypertensive drugs also occurred after surgery. Patients on antihypertensive drugs at last follow-up had longer hypertension duration before PTRA than those without (5.9 +/- 7.7 vs 1.8 +/- 4.1 years; P = 0.0349). Cure was achieved in 16 (24%), improvement in another 26(39%), and benefit in 42(63%). In conclusion, renal artery FMD, PTRA and surgery have beneficial long-term effects, negatively affected by hypertension duration and branch artery involvement.}}, author = {{Alhadad, Alaa and Mattiasson, Ingrid and Ivancev, Krassi and Gottsäter, Anders and Lindblad, Bengt}}, issn = {{1476-5527}}, keywords = {{surgical reconstruction; PTRA; fibromuscular dysplasia; renal artery; long-term follow-up}}, language = {{eng}}, number = {{10}}, pages = {{761--767}}, publisher = {{Nature Publishing Group}}, series = {{Journal of Human Hypertension}}, title = {{Revascularisation of renal artery stenosis caused by fibromuscular dysplasia: effects on blood pressure during 7-year follow-up are influenced by duration of hypertension and branch artery stenosis}}, url = {{http://dx.doi.org/10.1038/sj.jhh.1001893}}, doi = {{10.1038/sj.jhh.1001893}}, volume = {{19}}, year = {{2005}}, }