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Renovascular Hypertension Managed by Percutaneous Transluminal Renal Angioplasty Evaluating with Intravascular Ultrasound and Pressure Wire Satoru Touhara 1 , Yoshihiko Sakai 1 , Hirotoshi Kamishirado 1 , Toshiyuki Nakata 1 , Jun-ichirou Watanabe 1 , Toshihiko Uchida 1 , Saeko Tsuda 1 , Michiko Minai 1 , Terumi Hayashi 1 , Shigenori Morooka 1 , Minoru Simizu 2 1Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine 2Department of Cardiology, Kasukabe Central General Hospital Keyword: 経皮的腎動脈形成術 , 血管内超音波 , プレッシャーワイヤー , percutaneous transluminal renal angio-plasty(PTRA) , intravascular ultrasound(IVUS) , pressure wire pp.621-626
Published Date 2002/6/15
DOI https://doi.org/10.11477/mf.1404902490
  • Abstract
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We reported two cases of renovascular hypertension, one in a young man and the other in a middle-aged man.

Case 1 : A 24-year-old man had headache and showed a high level of plasma renin activity. His angio-graphy revealed a 99% stenosis of the left renal artery, so we performed percutaneous transluminal renal angio-plasty (PTRA) on him.

Case 2 : A 57-year-old man had hypertension that was drug-resistant, and his plasma renin activity had increased. His renal angiogram showed a PTRA to 99% stenosis of the left renal artery, and we performed PTRA to the stenosis.

By intravascular ultrasound (IVUS), the echogenic appearance of the intima and media of the case 1 stenotic lesion was suspected to be fibromuscular dysplasia (FMD). On the other hand, the diffuse high-echoic intima in case 2 was suspected to he atheroscle-rosis.

During the PTRA of both cases, the pressure gradient at the stenosis became normalized immediately with to use of the pressure wire, which was evidence of a suc-cessful result.

In conclusion, IVUS can easily evaluate the etiology of the stenotic lesion and pressure wire can determine the effectiveness of PTRA in patients with RVH.


Copyright © 2002, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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