Atherosclerotic renovascular disease and cardiovascular risk 1 other vascular beds. The prevalence of ARAS increases with age, particularly in the patients with a history of smoking, hypertension, diabetes, peripheral artery disease, or coronary artery disease (CAD). 6-8 ARAS is usually localized in the ostium and proximal third of the main renal artery, and sometimes the atherosclerotic plaque may extend into the renal artery. ARAS can affect one or both renal arteries, and at more advanced stages segmental and diffuse intrarenal atherosclerosis develops, predominantly in the patients with ischemic nephropathy. 1-3 ARAS can lead to the occurrence of resistant hypertension and can progressively impair the renal function. ARAS can cause serious cardiac complications, such as flash pulmonary edema or congestive heart failure (HF). [1][2][3] ARAS is a multifaceted disease due to the complex interplay between RAS, hypertension, and Introduction Renal vascular hypertension (RVHT) is one of the most common secondary forms of hypertension. It is estimated that 1% to 5% of all cases of hypertension can be attributed to this condition. The prevalence may reach up to 6.8% in the older population (>65 years). 1-3 RVHT is generally caused by progressive stenosis of the renal artery most often due to atherosclerosis, and less often due to fibromuscular dysplasia. 4 The remaining rare or very rare causes, that is, consequences of other stenotic lesions, vascular malformations, or thrombotic complications may also be responsible for development of RVHT. 5 Atherosclerotic renal artery stenosis (ARAS) accounts for approximately 90% to 95% percent of cases of renal artery stenosis (RAS) and is predominantly seen in the populations with other cardiovascular risk factors or atherosclerotic lesions in