Renal revascularization in resistant hypertension Article

Full Text via DOI: 10.1016/j.pcad.2019.12.001 PMID: 31821813 Web of Science: 000521520900010

Cited authors

  • Prince, Marloe; Gupta, Aashish; Bob-Manuel, Tamunoinemi; Tafur, Jose

Abstract

  • Renal artery stenosis (RAS) is a common cause of secondary hypertension (HTN) and may lead to resistant (refractory) HTN despite guideline directed medical therapy. Although randomized controlled trials comparing medical therapy to medical therapy and renal artery stenting have shown no benefit with renal artery stenting, according to comparative effectiveness reviews by the Agency for Healthcare Research and Quality, the trials did not enroll patients with the most severe RAS who would be more likely to benefit from renal stenting. Because of limitations of conventional angiography, it is important to assess the hemodynamic severity of moderate (50%-70%) RAS lesions with a hemodynamic measurement. We review techniques to optimize patient selection, to minimize procedural complications, and to facilitate durable patency of renal stenting. We also review the current ACC/AHA Guidelines and SCAI Appropriate Use Criteria as they relate to renal stenting. (C) 2019 Elsevier Inc. All rights reserved.

Publication date

  • 2020

Published in

International Standard Serial Number (ISSN)

  • 0033-0620

Start page

  • 58

End page

  • 63

Volume

  • 63

Issue

  • 1