Prevalence of renal artery stenosis requiring revascularization in patients initially referred for coronary angiography.
To evaluate the prevalence of clinically significant renal artery stenosis (RAS) in patients referred for coronary angiography, we analyzed data on 2,439 consecutive patients. Patients underwent selective renal angiography in conjunction with coronary angiography if refractory hypertension (blood pressure > 140/90 on two drugs) or flash pulmonary edema was present. A total of 1,089 renal arteries of 534 patients were evaluated. Twelve percent (137/1,089) of the renal arteries in 19% (101/534) of patients had > 70% diameter stenosis in at least one vessel. Bilateral renal artery stenosis was present in 26% (26/101) of patients. One hundred and thirty-two of the 137 vessels underwent stent revascularization due to clinical renovascular hypertension. Acute clinical success (< 20% diameter stenosis without death or urgent surgery) was 98% (99/101). Due to high prevalence and effective available treatment, we recommend routine screening for RAS in all patients with refractory hypertension referred for coronary angiography.
Khosla
Sandeep
S
Section of Cardiology and Endovascular Therapeutics, Mount Sinai Hospital Chicago, Illinois 60608, USA. khos@sinai.org
Kunjummen
Binu
B
Manda
Ravi
R
Khaleel
Rizwan
R
Kular
Rajnishpaul
R
Gladson
Marina
M
Razminia
Mansour
M
Guerrero
Mayra
M
Trivedi
Atul
A
Vidyarthi
Vasundhara
V
Elbzour
Monther
M
Ahmed
Aziz
A
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012077:Renal Artery / Q000000981:diagnostic imaging* / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D015607:Stents