title: Atherosclerotic renal artery stenosis in the post-CORAL era part 1: the renal penumbra concept and next-generation functional diagnostic imaging.
abstract: After three neutral trials in which renal artery stenting failed to improve renal function or reduce cardiovascular and renal events, the controversy surrounding diagnosis and treatment of atherosclerotic renal artery stenosis and renovascular hypertension has led to paradigm shifts in the diagnostic algorithm. Noninvasive determination of earlier events (cortex hypoxia and renal artery hemodynamic changes) will supersede late sequelae (calcific stenosis, renal cortical thinning). Therefore, this review proposes the concept of renal penumbra in defining at-risk ischemic renal parenchyma. The complex field of functional renal magnetic resonance imaging will be reviewed succinctly in a clinician-directed fashion.
authors.affiliation: Division of Interventional Radiology, Department of Radiology, Koc University School of Medicine, Istanbul, Turkey.
authors.forename: Alan Alper
authors.initials: AA
authors.lastname: Sag
authors.affiliation: Koc University School of Medicine, Istanbul, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Inal
authors.affiliation: Koc University School of Medicine, Istanbul, Turkey.
authors.forename: John
authors.initials: J
authors.lastname: Okcuoglu
authors.affiliation: INSERM, Centre d'Investigations cliniques-plurithématique 1433, Inserm U1116; CHU Nancy; Université de Lorraine; F-CRININI-CRCT network, Nancy, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rossignol
authors.affiliation: Instituto de Investigacion Sanitaria de la Fundacion Jimenez Diaz (IIS-FJD), School of Medicine, Universidad Autonoma de Madrid, Madrid, Spain; Fundacion Renal Iñigo Alvarez de Toledo-IRSIN and REDINREN, Madrid, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.affiliation: Department of Nephrology, Konya Numune State Hospital, Konya, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Afsar
authors.affiliation: Division of Interventional Radiology, Department of Radiology, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sos
authors.affiliation: Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey. Electronic address: mkanbay@ku.edu.tr.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
mesh_terms: D050197:Atherosclerosis / Q000150:complications*; D066264:Datasets as Topic; D003952:Diagnostic Imaging / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D057510:Endovascular Procedures / Q000379:methods; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D007511:Ischemia / Q000000981:diagnostic imaging; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D000072356:Parenchymal Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D016032:Randomized Controlled Trials as Topic; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D015607:Stents
keywords: Atherosclerosis; cardiovascular diseases; radiology; renovascular hypertension