• To establish an optimal approach for the patients with bilateral atherosclerotic renal artery stenosis, combined treatment involving percutaneous transluminal renal angioplasty and oral captopril was applied. Five patients were examined for effects of the combined treatment on blood pressure and renal function. After percutaneous transluminal renal angioplasty on one renal artery, the blood pressure (mean ± SD) fell from 210/118 26/8 to 176/104 11/9mm Hg without any deterioration of renal function. This reduced blood pressure was further lowered to 155/92 ± 6/3 mm Hg by adding captopril therapy. This level of blood pressure has been maintained for an average of 37 months. Significant increases in serum creatinine concentration were not observed (124 27 vs 141 44 μmol/L), and renal size has been sustained. These results indicate that combined treatment with percutaneous transluminal renal angioplasty and captopril is effective in reducing the blood pressure and preserving renal function as an approach for the patients with bilateral atherosclerotic renal artery stenosis.
(Arch Intern Med. 1989;149:1973-1976)
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