Renal artery stenosis

From Citizendium
Revision as of 06:37, 3 April 2009 by imported>Robert Badgett (→‎Treatment)
Jump to navigation Jump to search

Treatment

Various treatment options exist and no single therapy is superior to others according to a systematic review.[1]

A more recent trial suggests that surgery leads to better patency rates than angioplasty with stenting.[2]

Angioplasty with or without stents

Stenting improves the patency rates after angioplasty according to a randomized controlled trial.[3] This trial found no statistical significance in differences on blood pressure and renal function; however, this study excluded patients with reduced renal function due to their stensoses.

Surgery

Surgical revascularization may benefit patients with serum creatinine above 2.0 mg/dl.[4]

  1. Balk E, Raman G, Chung M, et al (December 2006). "Effectiveness of management strategies for renal artery stenosis: a systematic review". Ann. Intern. Med. 145 (12): 901–12. PMID 17062633[e]
  2. Balzer KM, Pfeiffer T, Rossbach S, et al (March 2009). "Prospective randomized trial of operative vs interventional treatment for renal artery ostial occlusive disease (RAOOD)". J. Vasc. Surg. 49 (3): 667–74; discussion 674–5. DOI:10.1016/j.jvs.2008.10.006. PMID 19135837. Research Blogging.
  3. van de Ven PJ, Kaatee R, Beutler JJ, et al (January 1999). "Arterial stenting and balloon angioplasty in ostial atherosclerotic renovascular disease: a randomised trial". Lancet 353 (9149): 282–6. DOI:10.1016/S0140-6736(98)04432-8. PMID 9929021. Research Blogging.
  4. Uzzo RG, Novick AC, Goormastic M, Mascha E, Pohl M (March 2002). "Medical versus surgical management of atherosclerotic renal artery stenosis". Transplant. Proc. 34 (2): 723–5. PMID 12009679[e]