Determination of Pressure Gradients During Renal Arteriography

Today we know that diminished blood flow to a kidney resulting in chronic renal ischemia is a cause of hypertension which in some instances is surgically correctable. With the advent of renal arteriography, a definitive study of hypertensive patients with an underlying renal vascular lesion became possible. Various criteria for selection of patients for arterial examination were established, and the important role of the history, the presence or absence of abdominal bruits, and the information gained from carefully performed excretory urography became obvious. Selection of patients for surgery in this general group may be quite difficult. An obvious, isolated, obstructive lesion of one renal artery with or without a corroborative differential renal function test, radioisotope renogram, or renoscan is nonetheless a good indication for surgical intervention. More subtle changes, however, such as a small, flat arteriosclerotic plaque with apparently little encroachment upon the arterial lumen present a serio...