Renal artery stenosis: when to intervene?
Indications and timing of revascularization for atherosclerotic renal artery stenosis are topics of considerable controversy. Labile hypertension, progressive renal failure, and flash pulmonary edema may be strong indications for revascularization, yet revascularization may carry significant morbidity and mortality risks. Medical therapy alone, however, may also risk deterioration of renal function with worsening morbidity and mortality. We report a case of renal artery stenosis illustrating some of the complexities of decision-making, the limitations of angiography, and the importance of physiologic testing.
Choo
Daniel C
DC
Division of Cardiology, University of Massachusetts Medical School, Worcester, MA 01655, USA. fisherd@ummhc.org
Fisher
Daniel Z
DZ
D000368:Aged; D000792:Angiography; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001026:Coronary Artery Bypass; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D012078:Renal Artery Obstruction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome
D000959:Antihypertensive Agents