Systemic hypertensionRenal Artery Stenosis in Patients With Resistant Hypertension
Section snippets
Methods
The study conducted in 2 centers included 37 consecutive patients with resistant hypertension and RAS, angiographically categorized as moderate (50% to 70%). All patients signed the informed consent form, and the study protocol was approved by local ethic committees. Resistant hypertension was defined as randomly measured values of arterial blood pressure exceeding the guideline values for diabetic and nondiabetic patients (>140/90 and >130/80 mm Hg, respectively), despite the use of ≥3
Results
Baseline parameters and angiographic data of all 37 patients are listed in Table 1. Procedural success was obtained in all cases. None of the patients demonstrated a significant aggravation of renal function in the follow-up. Measurements of TPG were conducted in all patients. Values obtained after hyperemia induction were significantly higher than those in baseline conditions. The results of pressure gradient measurements are listed in Table 2.
The entire study population was subjected to a
Discussion
This is one of the first studies of pressure gradient–guided renal artery stenting in patients with moderate RAS and resistant hypertension. We showed that referring to the TPG measurements in the population of patients with resistant renovascular hypertension and moderate RAS (50% to 70%) may be useful in identifying those patients who would benefit from the procedure of renal artery stenting. Our data demonstrated that MBG >22 mm Hg, measured using a pressure wire, is an independent predictor
Disclosures
The authors have no conflicts of interest to disclose.
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Hemodynamic Measurements for the Selection of Patients With Renal Artery Stenosis: A Systematic Review
2017, JACC: Cardiovascular InterventionsCitation Excerpt :A total of 565 records were found after searching MEDLINE and Embase, and after removal of 265 duplicates, 300 records were screened for eligibility, resulting in 15 studies with relevant information on the diagnostic value of renal hyperemia (Figure 2) (30–44). Because 3 selected studies had overlapping study cohorts (40–42) and study cohorts were heterogeneous, no qualitative synthesis of study data could be performed. An overview of the selected studies is included in Table 1.
Comparison of the renal hyperemic effects of papaverine and dopamine in patients with renal artery stenosis
2015, Journal of the American Society of HypertensionCitation Excerpt :A large randomized trial would be necessary to prove the hypothesis that measurement of post–dopamine translesional pressure gradient in RAS may be helpful in selecting patients who benefit from renal revascularization. However, based on previous observations,6,7 we believe that patients with dopamine–induced hyperemic translesional gradients of 20 mm Hg or more could be randomly assigned to undergo renal revascularization plus medical therapy or to receive medical therapy alone. Patients with hyperemic translesional gradients less than 20 mm Hg should receive medical therapy alone and be included in a registry.
CT-based fractional flow reserve: Development and expanded application
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2020, Hypertension ResearchSelection of Patients for Angioplasty for Treatment of Atherosclerotic Renovascular Disease: Predicting Responsive Patients
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This study was partially supported by Project “WroVasc—Integrated Cardiovascular Center”, cofinanced by the European Regional Development Fund, within Innovative Economy Operational Program, 2007 to 2013 realized in Regional Specialist Hospital, Research and Development Center in Wroclaw. “European Funds—for the development of innovative economy” (Wroclaw, Poland).
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