[Diagnosis and roentgeno-endovascular treatment of patients with renin-dependent arterial hypertension and secondary aldosteronism without damage to the main renal arteries].

Bilateral electrocoagulation of the central veins of the adrenals (ECVA) was performed in 13 patients with stable and malignant arterial hypertension (AH). The renin-dependent character of AH was supported by positive reaction of arterial pressure (AP) to the test dose of captopril (25 mg). The vasorenal origin of the impairment was excluded on the basis of the peripheral captopril test findings, pharmacorenography with captopril. Bilateral ECVA was done during angiography. The manipulation turned out technically successful in 11 left (85%) and 9 right (70%) adrenals. The AP began lowering from the first days of the intervention and got stabilized by day 4 to 5. There was a significant decline of AP within the observation period up to 1 year and a reduction of the elevated aldosterone content and plasma renin activity with the content of ACTH being unchanged. After the manipulation 2 patients could fully discontinue the intake of hypotensive drugs. In 11 patients, the dose of the drugs could be reduced.