[Percutaneous dilatation of renal artery stenoses. Apropos of 7 cases]

The authors report the results of percutaneous dilatation of renal artery stenoses, performed on 8 occasions in 7 patients. One patient had bilateral stenoses which were operated at two separate occasions. The authors had no complications and they confirm the stability of the results with a follow-up of up to 2 years. In the 4 cases with an isolated unilateral renal artery stenosis, dilatation of the artery led to normalization of the blood pressure within hours of the operation. When there was another cause for hypertension apart from the renal artery stenosis, the dilatation did not cause the blood pressure to return to normal, although the anatomical result was confirmed on arteriography. The authors then review the literature and compare the complications of surgery for renal artery stenoses with those occurring during or after percutaneous dilatation of the renal artery lumen. Because of the quality of the results, the complication rate and the good results obtained with percutaneous dilatation in the literature, the authors conclude that percutaneous dilatation of the renal artery lumen is the treatment of choice for these stenoses. The indication for this operation can be extended, as its aim is not only reduction of hypertension, but also to improve renal function and to avoid the risk of thrombosis on a very narrow stenosis. In this way, the indications for this operation extend to include a population which, up until now, has been excluded from surgery, such as elderly patients, patients with coronary disease, or with renal failure.