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December 1969

Arteriographic Pitfalls in the Diagnosis of Renovascular Hypertension

Author Affiliations

Nashville, Tenn
From the departments of surgery (Dr. Foster) and radiology (Drs. Klatte and Burko), Vanderbilt University School of Medicine, Nashville, Tenn.

Arch Surg. 1969;99(6):792-801. doi:10.1001/archsurg.1969.01340180116023

Renal arteriography has proved to be the best screening test for renovascular hypertension. Rapid-squence excretory urography and radioactive isotope renography, both utilized as screening tests, have proved to be less satisfactory because of a 10% to 20% incidence of false-negative results.1-3 The mere presence of a renal artery stenosis in a patient with hypertension does not establish a causal relationship. At present, the functional or pathophysiologic significance of a given renal artery stenosis can best be determined by split renal function studies (Howard and Stamey tests) or by renal venous renin assays. In our experience, the prognostic accuracy of each of these tests is about 95%.1,2

The purpose of this report is to call attention to certain misleading findings that may sometimes be encountered in renal arteriography. Recognition of these pitfalls in the interpretation of renal arteriograms may lead to more successful use of this radiographic method for

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