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Renal Artery Stenosis

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Abstract

Renal artery stenosis (RAS) is the anatomic narrowing of one or more of the arteries to the kidney(s), most commonly caused by atherosclerosis. This chapter will review the causes of renal artery stenosis (RAS), and the pathophysiological changes and clinical manifestations that may occur due to RAS. Additionally, it will discuss the noninvasive imaging tests that are used to demonstrate the presence of RAS, how to determine its hemodynamic significance, and the role percutaneous transluminal angioplasty and renal artery stent placement play in the treatment of RAS.

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References

  1. Goldblatt H, Lynch J, Hanzai RF, Summerville WW. Studies on experimental hypertension; production of persistent elevation of systolic blood pressure by means of renal ischemia. J Exp Med. 1934;59:347–79.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Textor SC, Lerman LO. Paradigm shifts in atherosclerotic renovascular disease: where are we now? J Am Soc Nephrol. 2015;26(9):2074–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Textor SC. Renal arterial disease and hypertension. Med Clin North Am. 2017;101:65–79.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Parikh SA, Shishehbor MH, Gray BH, White CJ, Jaff MR. SCAI expert consensus statement for renal artery stenting appropriate use. Catheter Cardiovasc Interv. 2014;84:1163–71.

    Article  PubMed  Google Scholar 

  5. Textor SC, McKusick MM. Renal artery stenosis: if and when to intervene. Curr Opin Nephrol Hypertens. 2016;25:144–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Messerli FH, Bangalore S. Renal denervation for resistant hypertension? N Engl J Med. 2014;370:1454–7.

    Article  CAS  PubMed  Google Scholar 

  7. Cooper CJ, Murphy TP, Cutlip DE, Jamerson K, Henrich W, Reid DM, et al. Stenting and medical therapy for atherosclerotic renal artery stenosis. The CORAL trial. N Engl J Med. 2014;370:13–22.

    Article  CAS  PubMed  Google Scholar 

  8. Carr TM, Sabri SS, Turba UC, Park AW, Saad WEA, Angle JF, Matsumoto AH. Stenting for atherosclerotic renal artery stenosis. Tech Vasc Interv Radiol. 2010;12:134–45.

    Article  Google Scholar 

  9. Olin JW, Froehlich J, Gu X, Bacharach JM, Eagle K, Gray BH, et al. The US registry for fibromuscular dysplasia: results in the first 447 patients. Circulation. 2012;125:3182–90.

    Article  PubMed  Google Scholar 

  10. O’Connor SC, Gornik HL. Recent developments in the understanding and management of fibromuscular dysplasia. JAHA. 2014;3:e001259.

    PubMed  PubMed Central  Google Scholar 

  11. Meuse MA, Turba UC, Sabri SS, Park AW, Saad WEA, Angle JF, Matsumoto AH. Treatment of renal artery fibromuscular dysplasia. Tech Vasc Interv Radiol. 2010;13:126–33.

    Article  PubMed  Google Scholar 

  12. Murphy TP, Cooper CC, Pencina KM, D'Agostino R, Massaro J, Cutlip DE, et al. Relationship of albuminuria and renal artery stent outcomes: results from the CORAL randomized clinical trial (Cardiovascular Outcomes with Renal Artery Lesions). Hypertension. 2016;68:1145–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Misra S, Khosla A, Allred J, Harmsen WS, Textor SC, McKusick MA. Mortality and renal replacement therapy after renal artery stent placement for atherosclerotic renovascular disease. J Vasc Interv Radiol. 2016;27(8):1215–24.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lewis S, Kadian-Dodov D, Bansai A, Lookstein RA. Multimodality imaging of fibromuscular dysplasia. Abdom Radiol. 2016;41:2048–60.

    Article  Google Scholar 

  15. Mamoulakis C, Tsarouhas K, Fragkiadoulak I, Heretis I, Wilks MF, Spandidos DA, et al. Contrast-induced nephropathy: basic concepts, pathophysiological implications and prevention strategies. Pharmacol Ther. 2017; 180: 99-112.

    Article  CAS  Google Scholar 

  16. Idee J, Fretellier N, Robic C, Corot C. The role of gadolinium chelates in the mechanism of nephrogenic systemic fibrosis: a critical update. Crit Rev Toxicol. 2014;44:895–913.

    Article  CAS  PubMed  Google Scholar 

  17. Noory E, Sritharan K, Zeller T. To stent or not to stent? Update on revascularization for atherosclerotic renovascular disease. Curr Hypertens Rep. 2016;18:45.

    Article  PubMed  Google Scholar 

  18. De Bruyne B, Manoharan G, Pijls NHJ, Verhamme K, Madaric J, Bartunek J, et al. Assessment of renal artery stenosis severity by pressure gradient measurements. J Am Coll Cardiol. 2006;48:1851–5.

    Article  PubMed  Google Scholar 

  19. Leesar MA, Varma J, Shapira A, Fahsah I, Raza ST, Elghoul Z, et al. Prediction of hypertension improvement after stenting of renal artery stenosis: comparative accuracy of translesional pressure gradients, intravascular ultrasound, and angiography. J Am Coll Cardiol. 2009;53:2363–71.

    Article  PubMed  Google Scholar 

  20. Dangas G, Laird JR Jr, Mehran R, Lansky AJ, Mintz GS, Leon MB. Intravascular ultrasound-guided renal artery stenting. J Endovasc Ther. 2001;8:238–47.

    Article  CAS  PubMed  Google Scholar 

  21. Raman G, Adam GP, Halladay CW, Langberg VN, Asodo IA, Balk EM. Comparative effectiveness of management strategies for renal artery stenosis. An updated systematic review. Ann Intern Med. 2016;165:635–49.

    Article  PubMed  Google Scholar 

  22. Tegtmeyer CJ, Selby JB, Hartwell GD, Ayers C, Tegtmeyer V. Results and complication of angioplasty in fibromuscular disease. Circulation. 1991;83(suppl):I155–61.

    PubMed  CAS  Google Scholar 

  23. Trinquart L, Mounier-Vehier C, Sapoval M, Gagnon N, Plouin P. Efficacy of revascularization for renal artery stenosis caused by fibromuscular dysplasia: a systematic review and meta-analysis. Hypertension. 2010;56:525–32.

    Article  CAS  PubMed  Google Scholar 

  24. Yang YK, Zhang Y, Meng X, Yang KQ, Jiang XJ, Wu HY, et al. Clinical characteristics and treatment of renal artery fibromuscular dysplasia with percutaneous transluminal angioplasty: a long-term follow-up study. Clin Res Cardiol. 2016;105:930–7.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Alan H. Matsumoto .

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Uflacker, A., Matsumoto, A.H. (2018). Renal Artery Stenosis. In: Keefe, N., Haskal, Z., Park, A., Angle, J. (eds) IR Playbook. Springer, Cham. https://doi.org/10.1007/978-3-319-71300-7_26

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  • DOI: https://doi.org/10.1007/978-3-319-71300-7_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-71299-4

  • Online ISBN: 978-3-319-71300-7

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