Abstract:

Purpose. Was to investigate ability of videodensitometry for assessment the effect of renal artery stenosis on parenchymal perfusion.

Materials and methods. Аngiographic data of 97 patients with and 55 patients without renal artery stenosis were analyzed by means of videodensitometry, using «Multivox» software. All patients underwent renal arteries duplex ultrasound and kidneys ultrasound examination.

Levels of blood pressure and kidney function as a clinical signs of renovascular hypertension were assessed. Risk factors of kidney parenchymal injury such as diabetes mellitus, chronic kidney diseases were monitored.

Results. Videodensitometric analysis allows to detect statistically significant differences in parenchymal perfusion between kidneys with and without renal artery stenosis. A grade of changes in parenchymal perfusion correlates with angiographicaly measured degree of renal artery stenosis and renal artery blood flow velocity.

Conclusion. Videodensitometric perfusion parameters can be used to assess the effect of renal artery stenosis on parenchymal blood flow.

Thus, videodensitometry extends diagnostic capability of angiographic study. 

References 

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Abstract:

Purpose: on the basis of long-term results of renal angioplasty and stenting, the authors define the indications for endovascular interventions in patients with renovascular hypertension (RVH).

Materials and methods: since 1992-2008 in Tashkent Medical Academy Vascular Surgery Center were performed 131 endovascular interventions in 119 patients for renal arteries (RA) stenoses of various origins. 97 patients underwent balloon angioplasty (BA) of renal arteries (105 interventions), and stenting was performed in 22 cases (26 stenting procedures). Systolic blood pressure varied from 170 to 300 mm Hg (219,4±23,1 mmHg), with diastolic blood pressure from 170 to 300 mm Hg (118,1±8,9 mm Hg). Average arterial hypertension history was 5,2±3,7 years (6 months - 16 years).

Results: technical success rate was 85,6% for balloon angioplasty, and 100 % for stenting procedures. Immediate hypotensive effect was good to satisfactory. Complication rate was 2,5% (3 patients). Long-term results were assessed in 76 cases of balloon angioplasty (78,4%), and in all patients with renal arteries stenting. The average follow-up was 72±32,5 months (6-144 months) for balloon angioplasty, and 6-24 months for stenting group. In the angioplasty group long-term hypotensive effect lasted in 54(71,1%) of patients, and the restenosis rate was as high as 28,9% (22 cases). In the stenting group, the long-term hypotensive effect was preserved in all the patients, and there were no cases of restenosis.

Conclusions: high rates of technical and clinical success, as well as low rates of restenosis, allow the renal artery stenting procedure to be seen as the method of choice for renovascular hypertension.

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