The efficacy of renal artery stent combined with optimal medical therapy in patients with severe atherosclerotic renal artery stenosis

Abstract

Renal artery stent combined with optimal medical therapy as a treatment has a beneficial effect on blood pressure control and estimated glomerular filtration rate in selected patients with atherosclerotic renal artery stenosis. Larger studies with a longer follow-up appear necessary to further confirm these intriguing findings.

Percutaneous transluminal angioplasty with selective stenting for the treatment of renal artery stenosis caused by fibromuscular dysplasia: 18 years' experience from the China Center for Cardiovascular Disease

“…Indications for endovascular therapy was defined as RAS ≥70% and Grade 3 hypertension without antihypertensive drugs, or systolic and diastolic pressures greater than 140 or 90 mmHg after treatment with triple antihypertensive drug therapy. The exclusion criteria for PTA with stent implantation were as follows: (a) intolerance to heparin or antiplatelet drugs, (b) renal artery dissection, (c) severe renal insufficiency (glomerular infiltration rate < 30 ml/min), (d) allergy to iodinated contrast agent, or (e) life expectancy <2 years. Consent was obtained from all individual participants included in the study.…”

“…Because histopathology was rarely available, the diagnosis was made based on angiographic imaging, including selective angiography or computed tomographic (CT) angiography. By analyzing the angiographic findings for the renal artery, stenosis was classified into three types: multifocal (multiple stenosis or string‐of‐beads appearance), unifocal (stenosis <1 cm in length), and tubular (stenosis ≥1 cm in length).…”

Renal artery stenting for atherosclerotic renal artery stenosis identified in patients with coronary artery disease: Does captopril renal scintigraphy predict outcomes?

“…34 Even larger BP reductions by an average of 20 mm Hg were also reported in uncontrolled studies. 35,36 However, these findings were not confirmed in four meta-analyses of randomized controlled trials 37-40 and a recent systematic review. 41 In addition, benefits seen in some studies may be more pronounced if appropriate subgroups were to be identified.…”

“…Regarding RVH, the majority of three retrospective and nine prospective cohort studies included in a recent meta‐analysis reported a decrease of BP after PRR, with the mean BP falling by approximately 10 mm Hg . Even larger BP reductions by an average of 20 mm Hg were also reported in uncontrolled studies . However, these findings were not confirmed in four meta‐analyses of randomized controlled trials and a recent systematic review .…”

Rare complication of subacute renal artery intramural haematoma after renal artery stenting: a case report

“…Stent implantation is a treatment for renovascular hypertension due to atherosclerotic renal artery stenosis 1 . Renal artery intramural haematoma (IMH) is a rare complication after renal artery stenting 2 .…”