Selective Renal Arteriography in the Diagnosis of Renal Hypertension.

RECOGNITION of renal arterial disease as a cause of hypertension has been made possible by the development of renal arteriography. Much of the earlier experienee in diagnosis of these lesions was gained with translumbar aortography. As helpful as this technic has been in opening up an important area for clinical study, its usefulness is often limited because it does not always give sufficient detail of the renal arterial supply. The contrast material may be so diluted by aortie blood that it fails to outline adequately the main renal arteries and branches; also, the renal arteries may be obscured by opacified overlying arteries, such as the superior mesenteric, hepatic, and splenic. Hypertension can be associated not only with lesions of main renal arteries and their interlobar (primary) branches but also with segmental or diffuse renal parenchymal diseases. Adequate differential diagnosis of these renal diseases requires an arteriographic technic that gives good detail of the entire renial arterial supplv. At the present time, the procedure of choice is selective renal arteriography. This report describes experience with this teehnie in 100 hypertensive patients.