title: Endovascular versus medical therapy for atherosclerotic renovascular disease.
abstract: The diagnosis of renal artery stenosis (RAS) has become increasingly common in part due to greater awareness of ischemic renal disease and increased use of diagnostic techniques. Over 90 % of RAS cases are caused by atherosclerotic renovascular disease (ARVD). Patients with ARVD are at high risk for fatal and nonfatal cardiovascular and renal events. The mortality rate in patients with ARVD is high, especially with other cardiovascular or renal comorbidities. Recent clinical studies have provided substantial evidence concerning medical therapy and endovascular interventional therapeutic approaches for ARVD. Despite previous randomized clinical trials, the optimal therapy for ARVD remained uncertain until the results of the Cardiovascular Outcomes in Renal Atherosclerotic Lesions (CORAL) trial were released recently. CORAL demonstrated that optimal medical therapy was equally effective to endovascular therapy in the treatment of ARVD. Clinicians can now practice with more evidence-based medicine to treat ARVD and potentially decrease mortality in patients with ARVD using optimal medical therapy.
authors.affiliation: Department of Medicine, University of Toledo, 3000 Arlington Ave, Toledo, OH, 43614, USA, shipeng.yu@utoledo.edu.
authors.forename: Mark Shipeng
authors.initials: MS
authors.lastname: Yu
authors.forename: David A
authors.initials: DA
authors.lastname: Folt
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Drummond
authors.forename: Steven T
authors.initials: ST
authors.lastname: Haller
authors.forename: Emily L
authors.initials: EL
authors.lastname: Cooper
authors.forename: Pamela
authors.initials: P
authors.lastname: Brewster
authors.forename: Kaleigh L
authors.initials: KL
authors.lastname: Evans
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Cooper
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000473:pathology*; D057510:Endovascular Procedures / Q000379:methods; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012078:Renal Artery Obstruction / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents