Digital subtraction angiography in the evaluation of hypertension

Thirty-five patients with high blood pressure underwent digital intravenous subtraction angiography (DSA) for evaluation of renovascular disease. Eight had recurrent hypertension after renal transplantation, and four after aortorenal bypass. Twenty-three had DSA as part of a hypertensive screening workup for renovascular disease. Diagnostic studies were obtained in 33 patients. Twelve patients had confirmatory arteriograms and agreement occurred in 10. DSA detected significant pathology in nine of the post-renal-surgery patients. DSA followed by a minimal number of overhead abdominal films to evaluate the renal parenchyma, ureters, and bladder was found to be a preferable alternative to the conventional rapid-sequence excretory urogram as a screening test for patients with suspected renovascular disease.