Renovascular Hypertension

Dean, Richard H.; Kieffer, Robert W.; Smith, Blaine E.; Oates, John A.; Nadeau, John; Hollifield, John W.; Dupont, William D.

doi:10.1001/archsurg.1981.01380230032005

Cited by 273 publications

(7 citation statements)

References 2 publications

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“…[1][2][3] The natural history of RAS is progressive, and treatment options include surgical revascularization or angioplasty with stenting. [4][5][6][7][8] Current guidelines 9 recommend using captopril renal scanning (CRS), duplex Doppler flow studies, or magnetic resonance angiography as initial noninvasive screening tests 9 in patients who are suspected of having renovascular disease. Although no consensus exists regarding the single "best" test, 1,10-13 many clinicians rely on CRS as the preferred initial approach because of its purported role in identifying patients who would benefit (in terms of blood pressure control) from revascularization.…”

Section: Discussionmentioning

confidence: 99%

Utility of Captopril Renal Scans for Detecting Renal Artery Stenosis

Huot¹,

Hansson²,

Dey³

et al. 2002

Arch Intern Med

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Section: Discussionmentioning

confidence: 99%

Utility of Captopril Renal Scans for Detecting Renal Artery Stenosis

Huot¹,

Hansson²,

Dey³

et al. 2002

Arch Intern Med

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“…Novick et al [68] reported their experience on a modest number of patients, and they demonstrated an improvement in two thirds of them during the follow-up period. Additionally, Dean et al [69] reported the same results in patients with bilateral occlusive disease and serum creatinine values above 3.0 mg/dL. It was clear that this subgroup of patients had the highest apparent benefit from surgical treatment.…”

Section: Treatment Optionsmentioning

confidence: 80%

Endovascular Management of Atherosclerotic Renal Artery Stenosis: Post-Cardiovascular Outcomes in Renal Atherosclerotic Lesions Era Winner or False Alarm?

Karanikola

Karaolanis

Galyfos

et al. 2017

VSI

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Renal artery stenosis (RAS) is frequently associated with severe comorbidities such as reduced renal perfusion, hypertension, and end-stage renal failure. In approximately 90% of patients, renal artery atherosclerosis is the main cause for RAS, and it is associated with an increased risk for fatal and non-fatal cardiovascular and renal complications. Endovascular management of atherosclerotic RAS (ARAS) has been recently evaluated by several randomized controlled trials that failed to demonstrate benefit of stenting. Furthermore, the Cardiovascular Outcomes in Renal Atherosclerotic Lesions study did not demonstrate any benefit over the revascularization approach. In this review, we summarized the available data from retrospective, prospective and randomized trials on ARAS to provide clinicians with sufficient data in order to produce useful conclusions for everyday clinical practice.

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“…In consequence, it is often difficult to determine the absolute or relative advantage of this approach and to what degree patient selection accounts for the outcomes of these studies. Dean et al have reported some of the best surgical results indicating that patients with bilateral occlusive disease and moderate azotemia or a serum creatinine above 3.0 mg/dL had the greatest apparent benefit from surgical revascularization [57]. Overall, however, a significant association between the degree of stenosis and the benefit of revascularization has yet to be established.…”

Section: Revascularization and Endovascular Therapymentioning

confidence: 99%

Endovascular Versus Medical Therapy for Atherosclerotic Renovascular Disease

Folt

Drummond

et al. 2014

Curr Atheroscler Rep

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The diagnosis of renal artery stenosis (RAS) has become increasingly common in part due to greater awareness of ischemic renal disease and increased use of diagnostic techniques. Over 90 % of RAS cases are caused by atherosclerotic renovascular disease (ARVD). Patients with ARVD are at high risk for fatal and nonfatal cardiovascular and renal events. The mortality rate in patients with ARVD is high, especially with other cardiovascular or renal comorbidities. Recent clinical studies have provided substantial evidence concerning medical therapy and endovascular interventional therapeutic approaches for ARVD. Despite previous randomized clinical trials, the optimal therapy for ARVD remained uncertain until the results of the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) trial were released recently. CORAL demonstrated that optimal medical therapy was equally effective to endovascular therapy in the treatment of ARVD. Clinicians can now practice with more evidence-based medicine to treat ARVD and potentially decrease mortality in patients with ARVD using optimal medical therapy.

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Renovascular Hypertension

Cited by 273 publications

References 2 publications

Utility of Captopril Renal Scans for Detecting Renal Artery Stenosis

Utility of Captopril Renal Scans for Detecting Renal Artery Stenosis

Endovascular Management of Atherosclerotic Renal Artery Stenosis: Post-Cardiovascular Outcomes in Renal Atherosclerotic Lesions Era Winner or False Alarm?

Endovascular Versus Medical Therapy for Atherosclerotic Renovascular Disease

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