[Combined intravenous arteriography and pyelography in hypertension. I. -- Technical and diagnostical aspects on the bases of 475 cases (author's transl)].

Renal arteriogram can be obtained by a rapid injection (15-22 ml/s) of a venous bolus of 2-3 ml/kg B.W. of contrast media at 38 p. 100 and followed by an excretory pyelography with early films and wash out by furosemide to determine the functional significance of an eventual stenosis in a hypertensive patient. Analysis of 2 000 such radiological examinations, 475 of which done in hypertensive patients, showed that a stenosis could be adequatly detected in 70 p. cent of the cases when only one arteriographic film was taken and in 95 p. 100 of the cases when 6 films were taken with a film changer. With this latter technique the morphological information was comparable to that obtained with the Seldinger technique. This latter was however necessary to confirm the stenosis preoperatively when only one arteriographic film was taken. Tolerance of the examination was good in spite of transitory heat sensation and headache in 66 p. cent of the cases. The examination of 475 hypertensive patients led to discover 55 renal artery stenosis, 12 of which were functionnal, 4 aneurysms (1 of the renal artery, 2 of the aorta, and 1 of the hepatic artery) and one coarctation.

CONCLUSIONS

combined intravenous arteriography and pyelography is a valuable technic, as regards, safety and efficiency in the diagnosis of renovascular hypertension. This warrants a comparison of this technique with the classical diagnostic approach of renovascular hypertension as regards its diagnostic efficiency and cost for the community.