Percutaneous renal artery intervention versus medical therapy in patients with renal artery stenosis: a meta-analysis

Abstract

We did not find a significant improvement in blood pressure or renal function in patients with renal artery stenosis treated with renal artery revascularisation compared to medical therapy alone. However, trial quality was a limitation.

Update on intervention versus medical therapy for atherosclerotic renal artery stenosis

“…In a systematic review, 54 the authors concluded that EPDs may be beneficial in some patients, but there was inadequate empirical data to clearly define the risk/benefit. In a small four-arm randomized study of 100 patients, it was noted that the use of adjuvant IIb/IIIa glycoprotein inhibitors and EPDs may have a synergistic benefit.…”

“…57 Another meta-analysis study showed no benefit between the two arms. 54 Some studies have shown that the only benefit is blood pressure control, not renal function. 55,58,59 …”

Renal Sympathetic Denervation in a Previously Stented Renal Artery

“…Moreover, a meta-analysis did not find an improvement in blood pressure (BP) in patients with renal artery stenosis treated with renal artery stenting. 4 Therefore, a double mechanism maintains hypertension: renovascular and sympathetic tone. In the following, we report the case of a patient with RH treated by RDN after renal artery stenting.…”

Stenting Versus Medical Treatment for Renal Atherosclerotic Artery Stenosis

“…16,17 This lack of benefit could be related to the fact that most patients with RAS may have essential hypertension complicated by a renovascular disease. It is also possible that a late chronic stage of RAS hypertension is no longer directly dependent on the RAA system but on local vasoconstrictor and proliferative effects in the arterial wall leading to renal artery revascularization inefficacy.…”