Renal artery angioplasty: increased technical success and decreased complications in the second 100 patients

In 200 consecutive patients undergoing percutaneous transluminal renal angioplasty (PTRA), a significant increase in primary success rate (P less than .02) and a concomitant decrease in complications were noted in the second 100 patients. The primary success rate increased from 93% to 97%, and the incidence of total complications fell from 20% to 13%. The incidence of complications requiring surgery fell from 5% to 2%, and the incidence of renal failure declined from 10% to 5% of the patient population. Variables that contributed to improvement in the procedure included new approaches to crossing arterial stenoses, increased use of digital imaging, less contrast material used in each case, better hydration of patients, and increased use of vascular sheaths at the puncture site.