title: How to manage hypertension with atherosclerotic renal artery stenosis?
abstract: The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS.
authors.affiliation: Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France - jeanbaptistericco@gmail.com.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Ricco
authors.affiliation: Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Belmonte
authors.affiliation: F. Durante Department of Surgical Sciences, La Sapienza University, Rome, Italy.
authors.forename: Guilio
authors.initials: G
authors.lastname: Illuminati
authors.affiliation: Department of Vascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Barral
authors.affiliation: Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Schneider
authors.affiliation: Department of Vascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Chavent
mesh_terms: D000792:Angiography; D017130:Angioplasty / Q000295:instrumentation; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000187:drug effects*; D002986:Clinical Trials as Topic; D004691:Endarterectomy / Q000009:adverse effects; D019317:Evidence-Based Medicine; D006801:Humans; D006978:Hypertension, Renovascular / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D058017:Vascular Grafting / Q000009:adverse effects; D014654:Vascular Patency
chemical_list: D000959:Antihypertensive Agents