Renal artery stenosis: anatomic classification for percutaneous transluminal angioplasty

Cicuto, KP; McLean, GK; Oleaga, Juan A.; Freiman, DB; Ra, Grossman; Ring, EJ

doi:10.2214/ajr.137.3.599

Cited by 138 publications

(18 citation statements)

References 3 publications

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“…Finally, in patients with a solitary kidney or bilateral RAS, the ability of the patient to tolerate long-term administration of angiotensin antagonist medications may be facilitated by relief of a hemodynamic renal artery obstruction. Percutaneous transluminal renal balloon angioplasty is the treatment of choice for symptomatic RAS caused by FMD (744,(768)(769)(770). However, in atherosclerotic RAS, balloon angioplasty alone is associated with a lower procedural success rate and a higher restenosis rate (745,(771)(772)(773)(774)(775)(776)(777).…”

Section: Impact Of Ras On Congestive Heart Failure and Unstable Anginamentioning

confidence: 99%

“…Aortoostial stenoses represent the most common atherosclerotic lesions and are prone to vascular recoil due to confluent plaque that extends from the wall of the aorta into the ostium of the renal artery. These atherosclerotic aorto-ostial lesions are generally considered unsuitable for treatment by balloon angioplasty alone (769,770,778).…”

Section: Impact Of Ras On Congestive Heart Failure and Unstable Anginamentioning

confidence: 99%

See 1 more Smart Citation

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,967

1,111

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Section: Impact Of Ras On Congestive Heart Failure and Unstable Anginamentioning

confidence: 99%

Section: Impact Of Ras On Congestive Heart Failure and Unstable Anginamentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,967

1,111

View full text Add to dashboard Cite

“…In this setting, PTRA may fail in up to 75% of cases. [109][110][111] These limitations have been overcome, to an extent, by the availability of renal artery stents. First described in 1987, 112 early studies confirmed the benefits of stents in overcoming many of the limitations of failed PTRA.…”

Section: Renal Artery Revascularizationmentioning

confidence: 99%

The role of percutaneous revascularization for renal artery stenosis

Dubel

Murphy

2008

Vasc Med

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Renal artery stenosis (RAS) is usually caused by atherosclerosis or fibromuscular dysplasia. RAS leads to activation of the renin-angiotensin-aldosterone system and may result in hypertension, ischemic nephropathy, left ventricular hypertrophy and congestive heart failure. Management options include medical therapy and revascularization procedures. Recent studies have shown angiotensin receptor blockers (ARB) and angiotensin converting enzyme inhibitors (ACE-I) to be highly effective in treating the hypertension associated with RAS and in reducing cardiovascular events; however, they do not correct the underlying RAS and loss of renal mass may continue. Renal artery angioplasty was first performed by Gruntzig in 1978. The routine use of stents has increased technical success rates compared with angioplasty, and surgery is now only rarely performed. Although numerous case series claimed benefit in terms of blood pressure control, no adequately powered randomized, controlled, prospective study of renal artery interventions has reported their effect on cardiovascular morbidity or mortality. The CORAL trial, an ongoing study of renal artery stent placement and optimal medical therapy (OMT) funded by the National Institutes of Health, is the first study to attempt to do so. Until the CORAL trial results are in, physicians will continue to be faced with difficult choices when determining the optimal management for RAS patients and deciding which, if any, patients should be offered revascularization.

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“…Aorto-ostial stenoses represent the most common atherosclerotic lesions and are prone to vascular recoil due to confluent plaque that extends from the wall of the aorta into the ostium of the renal artery. These atherosclerotic aorto-ostial lesions are generally considered unsuitable for treatment by balloon angioplasty alone (197,198,206).…”

Section: Percutaneous Revascularization Is Reasonable For Patients Wimentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary

Wilkins¹

2006

Circulation

131

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Renal artery stenosis: anatomic classification for percutaneous transluminal angioplasty

Cited by 138 publications

References 3 publications

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

The role of percutaneous revascularization for renal artery stenosis

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): Executive Summary

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