Renal artery stenting: indications, techniques, and devices

Renal artery stenosis is a prevalent condition that has been implicated in the pathogenesis of renovascular hypertension, chronic kidney disease, and cardiac disturbance syndromes. The most common causes of renal artery stenosis are atherosclerosis and fibromuscular dysplasia. Endovascular revascularization of renal artery stenosis is controversial, but may have significant benefits for treatment of renovascular symptoms in carefully selected patients. In this review, we evaluate the literature and discuss indications for endovascular revascularization of renal artery stenosis. Technical aspects of renal artery stenting are addressed, including methods to avoid procedural complications and use of embolic protection devices. The role of drug eluting stents is examined, as are approaches to the detection and treatment of in-stent restenosis.