Document Detail


Changes in renal blood flow reserve after angioplasty of renal artery stenosis in hypertensive patients.
MedLine Citation:
PMID:  14675056     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intra-arterial Doppler is a recent technique which allows assessment of distal vascular disease using measurements of intrarenal blood flow velocities. The purpose of this study was to evaluate intrarenal hemodynamics and renal blood flow reserve before and after percutaneous transluminal angioplasty (PTA) in hypertensive patients with unilateral atherosclerotic renal artery stenosis using intra-arterial Doppler. METHODS: Intra-arterial Doppler was performed during arteriography in 19 hypertensive patients (12 men; mean age, 64 +/- 8 years) in "normal" and in "stenotic" kidneys at baseline, on isosorbide dinitrate, and after selective intra-renal papaverine injection, before, and after PTA. Doppler parameters analyzed were average peak velocity, maximum peak velocity, end diastolic velocity, and renal blood flow (RBF). Changes in Doppler parameters after papaverine injection were also analyzed. RESULTS: The major results were (1) the significant reduction in RBF distal to the stenosis, (2) the lack of arteriolar reactivity in response to papaverine distal to the stenosis, (3) the immediate recovery of arteriolar reactivity after PTA, associated with restoration of RBF in the revascularized kidneys, and (4) no change in arteriolar reactivity in response to papaverine in the "normal" kidneys following PTA. CONCLUSION: Ours results highlighted the benefit of endovascular Doppler to evaluate (1) RBF reserve, and (2) the repercussion of the stenosis on the distal vascularization.
Authors:
Claire Mounier-Vehier; Benjamin Cocheteux; Stephan Haulon; Patrick Devos; Christophe Lions; Corinne Gautier; Alain Carre; Jean-Paul Beregi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Kidney international     Volume:  65     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-09-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-50     Citation Subset:  IM    
Affiliation:
Service de Médecine Interne et HTA, Hôpital Cardiologique, CHRU, Lille Cédex, France. cmouniervehier@chru-lille.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon*
Female
Humans
Hypertension, Renal / physiopathology,  therapy*,  ultrasonography*
Male
Middle Aged
Papaverine / administration & dosage
Renal Artery Obstruction / physiopathology,  therapy*,  ultrasonography*
Renal Circulation
Ultrasonography, Doppler
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-74-2/Papaverine

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