Renal Artery Stenosis: When to Revascularize in 2017 Article

Full Text via DOI: 10.1016/j.cpcardio1.2017.01.004 PMID: 28325353 Web of Science: 000398013400002

Cited authors

  • Tafur, Jose D.; White, Christopher J.


  • Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension; it can also cause progressive renal insufficiency and cardiovascular complications such as refractory heart failure and flash pulmonary edema. Medical therapy including risk factor modification, renin-angiotensin-aldosterone system antagonists, lipid lowering agents, and antiplatelet therapy is the first line of treatment in all patients. Patients with uncontrolled renovascular hypertension despite optimal medical therapy, ischemic nephropathy, and cardiac destabilization syndromes who have severe renal artery stenosis are likely to benefit from renal artery revascularization. Screening for renal artery stenosis can be done with Doppler ultrasonography, computed tomographic angiography and magnetic resonance angiography. Invasive physiologic measurements are useful to confirm the severity of renal hypoperfusion and therefore improve the selection patients likely to respond to renal artery revascularization. Primary patency exceeds 80% at 5 years and surveillance for in-stent restenosis can be done with periodic clinical, laboratory, and imaging follow-up.

Publication date

  • 2017

Published in

International Standard Serial Number (ISSN)

  • 0146-2806

Start page

  • 110

End page

  • 134


  • 42


  • 4