Document Detail


Renal atrophy in atherosclerotic renovascular disease: gradual changes 6 months after successful angioplasty.
MedLine Citation:
PMID:  12546589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess renal morphology using spiral computed tomographic angiography (CTA) before and 6 months after angioplasty of unilateral atherosclerotic renal artery stenosis (RAS). METHODS: Spiral CTA scans from 14 hypertensive patients (7 men; mean age 57.4 +/- 13.1 years) with significant RAS were performed before and 6 months after angioplasty; renal length, mean cortical thickness (MCT), cortical area (CA), and medullary length (ML) were measured from the axial slices in the 14 contralateral and 14 poststenotic then revascularized kidneys. Blood pressure, creatinine clearance, and number of antihypertensive drugs were analyzed. RESULTS: At 6 months, the systolic blood pressure was significantly reduced (p=0.007), but the number of antihypertensive drugs and the creatinine clearance did not change significantly. Most morphological parameters before and after angioplasty were different in the contralateral versus poststenotic kidneys (renal length, p=0.01; MCT, p=0.01; ML, p=0.03; CA, p=0.008). After angioplasty, there was an 11% drop in cortical atrophy associated with a mean 4-mm increase in medullary length in the poststenotic/revascularized kidneys. The contralateral kidneys exhibited corticomedullary thinning after angioplasty. CONCLUSIONS: In atherosclerotic renal disease, cortical thinning could be a useful timesaving marker to assess the significance of the lesion and to evaluate associated distal lesions. The favorable blood pressure outcome supports the existence of reversible ischemic lesions, particularly in the medulla. Angioplasty appears to be useful for the poststenotic kidney, according to the morphological study.
Authors:
Claire Mounier-Véhier; Stéphan Haulon; Christophe Lions; Patrick Devos; Olivier Jaboureck; Serge Willoteaux; Alain Carré; Jean-Paul Beregi
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  9     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-01-27     Completed Date:  2003-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  863-72     Citation Subset:  IM    
Affiliation:
Services de Médecine Interne et HTA, Hôpital Cardiologique, CHRU, Lille Cedex, France. cmouniervehier@chru-lille.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Balloon
Arteriosclerosis / complications*,  physiopathology,  radiography
Atrophy / etiology,  physiopathology,  radiography
Blood Pressure / drug effects,  physiology
Diastole / physiology
Female
Humans
Hypertension, Renovascular / complications*,  physiopathology,  radiography
Kidney / pathology*,  radiography
Male
Middle Aged
Renal Artery Obstruction / physiopathology,  radiography,  therapy*
Systole / physiology
Time Factors
Tomography, X-Ray Computed
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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