Document Detail


Current advances in the diagnosis and treatment of renal artery stenosis.
MedLine Citation:
PMID:  15580159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Renal artery stenosis (RAS) is a common condition associated with hypertension and renal insufficiency. The high prevalence of RAS patients with coronary and lower extremity vascular disease has been well established. Fibromuscular dysplasia in young females and atherosclerosis in patients over the age of 55 are the most common causes. Poorly controlled hypertension refractory to medical therapy, worsening of renal function, and flash pulmonary edema may point to underlying RAS. Duplex ultrasonography and magnetic resonance angiography have largely replaced captopril scanning for RAS screening. However, renal angiography still remains the gold standard to diagnose RAS. Treatment options include medical therapy, angioplasty, and surgery. In general, patients with a stenosis greater than 50%, a translesional systolic pressure gradient greater than 15 mm Hg, and difficult-to-control hypertension and/or worsening renal insufficiency are candidates for renal revascularization. Percutaneous transluminal revascularization has evolved to become the preferred revascularization therapy because it is a less invasive and more cost-effective alternative to surgery and is associated with high technical success, as well as a low complication rate. The natural history of RAS is to progress over time, leading to renal artery occlusion, loss of renal mass, worsening of renal function, and, ultimately, end-stage renal disease. It is therefore important to aggressively screen, recognize, and treat the entity early in its course.
Authors:
Syed W Bokhari; David P Faxon
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Reviews in cardiovascular medicine     Volume:  5     ISSN:  1530-6550     ISO Abbreviation:  Rev Cardiovasc Med     Publication Date:  2004  
Date Detail:
Created Date:  2004-12-06     Completed Date:  2005-01-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100960007     Medline TA:  Rev Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-15     Citation Subset:  IM    
Affiliation:
Section of Cardiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
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MeSH Terms
Descriptor/Qualifier:
Humans
Prognosis
Renal Artery Obstruction / diagnosis*,  etiology,  physiopathology,  therapy*

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