Angioplasty for Renal Artery Fibromuscular Dysplasia in Older Hypertensive Patients

Aim: To describe the outcomes of treating patients with angioplasty who are older than 40 years with symptomatic/labile/refractory hypertension (HTN). Methods: Between1999 and 2005, 28 patients underwent angioplasty for renal fibromuscular dysplasia (FMD). Patients were excluded if they had concomitant atherosclerotic renal artery stenosis (n = 4) or less than 1 month follow-up (n = 8). Results: The study group included 16 Caucasians (21 procedures; mean age 65.5 10.8 years; females = 88%). The cardiovascular risk factors include HTN (n = 13), smoking (n = 1), diabetes (n = 2), dyslipidemia (n = 8). The HTN was characterized as refractory (n = 15, 12 were symptomatic) and new-onset in 1 patient. The technical success rate was 100%. Over a median period of 12.8 months (range: 1.0-85.8), 18 (95%) procedures ‘‘failed,’’ of which 8 (42%) within 1 month and the rest in 1 year. Conclusions: Angioplasty in symptomatic renal FMD in patients >40 years is associated with poor outcomes possibly due to early restenosis.