Randomized trials in angioplasty and stenting of the renal artery: tabular review of the literature and critical analysis of their results.
As the incidence of hypertension (HTN) continues to rise, finding the optimal treatment of this multifactorial disease is critical. Renal artery stenosis (RAS) is a known etiology for HTN and is associated with declining renal function. Other than medications, the original gold standard for treatment of HTN from RAS was with an open surgical revascularization or nephrectomy. Since then, endovascular interventions for RAS have been reported to be technically possible, but their efficacy over medications or surgery has yielded conflicting results in case series and randomized trials. This tabular review summarizes the results of randomized trials that compared the outcomes of endovascular renal artery interventions with nonendovascular techniques (including medical and surgical treatments) for the treatment of HTN and renal dysfunction. Based on these data, the strengths and weaknesses of individual trials are critically analyzed to better define the methods to identify and treat patients with RAS.
Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA. guiescob@umich.edu
Guillermo A
GA
Escobar
Danielle N
DN
Campbell
D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D019317:Evidence-Based Medicine; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D012077:Renal Artery / Q000503:physiopathology / Q000601:surgery; D012078:Renal Artery Obstruction / Q000150:complications / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D015607:Stents; D016896:Treatment Outcome
D000959:Antihypertensive Agents