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Related Concept Videos

Imaging Studies VII: Vascular Imaging01:19

Imaging Studies VII: Vascular Imaging

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DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
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SCAI expert consensus statement for renal artery stenting appropriate use.

Sahil A Parikh1, Mehdi H Shishehbor, Bruce H Gray

  • 1University Hospitals Case Medical Center, Harrington Heart and Vascular Institute and Case Western Reserve University School of Medicine, Cleveland, Ohio.

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Renal artery stenting is a key treatment for renovascular hypertension caused by atherosclerotic renal artery stenosis (RAS). While trials show limited benefit, expert guidance is needed for optimal patient selection and best practices in stenting.

Keywords:
renal artery stenosisrenovascular hypertensionstent

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Area of Science:

  • Cardiology
  • Nephrology
  • Vascular Surgery

Background:

  • Atherosclerotic renal artery stenosis (RAS) activates the renin-angiotensin-aldosterone axis, leading to renovascular hypertension.
  • Renal artery stenting is the primary revascularization strategy for hemodynamically significant RAS.
  • Debate exists regarding medical therapy versus stenting for renovascular hypertension.

Purpose of the Study:

  • To guide physicians on the practical application of renal stenting for atherosclerotic RAS.
  • To highlight limitations in current literature and suggest best practices.
  • To identify opportunities for advancing the field of renal stenting.

Main Methods:

  • Review of modern prospective, multicenter registries.
  • Analysis of randomized, controlled clinical trials comparing medical therapy and renal stenting.
  • Expert consensus on best practices and future research directions.

Main Results:

  • Registries show blood pressure improvement and safety with renal stenting in RAS patients.
  • Clinical trials often excluded patients who might benefit from stenting, showing limited renal function preservation.
  • Significant debate persists on the optimal treatment strategy.

Conclusions:

  • Renal artery stenting remains a crucial intervention for select patients with atherosclerotic RAS and renovascular hypertension.
  • Further research and refined patient selection criteria are necessary to optimize outcomes.
  • Best practices in renal stenting performance are essential for maximizing benefits and safety.