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[Treatment of renal artery stenosis]

X Girerd1, P F Plouin

  • 1Fédération d'hypertension artérielle, Hôpital Broussais, Paris.

La Revue Du Praticien
|May 1, 1996
PubMed

Insights

Interventional radiology, specifically transluminal angioplasty, is recommended as the initial treatment for renovascular hypertension without renal failure. Surgery is reserved for complex cases or when angioplasty fails.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Radiology
  • Nephrology

Context:

  • Renovascular disease management involves surgical revascularization, medical therapy, and interventional radiology.
  • Transluminal angioplasty offers a less invasive alternative to surgery for specific patient groups.

Purpose:

  • To compare the efficacy of interventional radiology versus surgical revascularization in managing renovascular disease.
  • To identify optimal patient candidates and indications for transluminal angioplasty.

Summary:

  • Interventional radiology, particularly transluminal angioplasty, is indicated as the primary treatment for renovascular hypertension in patients without renal failure.
  • Fibrous dysplasia and atherosclerotic stenosis with pulmonary edema are prime indications for angioplasty.
  • Restenosis, especially in atherosclerotic cases, may necessitate repeat angioplasty or stenting; surgery is reserved for complex or refractory cases.

Impact:

  • Establishes interventional radiology as a first-line therapy for select renovascular hypertension patients.
  • Provides guidance on selecting appropriate treatments based on renal function and lesion complexity.
  • Highlights the potential for repeat interventions and surgical salvage in managing complex renovascular conditions.

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