Abstract
Clinical management of renal artery stenosis has seen a major shift, after randomised clinical trials have shown no group benefit of endovascular intervention relative to optimal medical control. However, the inclusion criteria of these trials have been criticised for focusing on a subset of patients with atherosclerotic renal artery stenosis where intervention was unlikely to be beneficial. Moreover, new imaging and computational techniques have become available, which have the potential to improve identification of patients that will respond to interventional treatment. This review addresses the challenges associated with clinical decision making in patients with renal artery stenosis. Opportunities for novel diagnostic techniques to improve patient selection are discussed, along with ongoing Dutch studies and network initiatives that investigate these strategies.
Original language | English |
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Pages (from-to) | 232-238 |
Number of pages | 7 |
Journal | Netherlands Journal of Medicine |
Volume | 78 |
Issue number | 5 |
Publication status | Published - 1 Sept 2020 |
Keywords
- angiography
- angioplasty
- blood-pressure
- computational fluid dynamics
- fibromuscular dysplasia
- follow-up
- fractional flow reserve
- functional measurements
- long-term outcomes
- medical therapy
- renal artery stenosis
- renovascular disease
- revascularization
- secondary hypertension
- stent placement
- FOLLOW-UP
- BLOOD-PRESSURE
- ANGIOPLASTY
- MEDICAL THERAPY
- FRACTIONAL FLOW RESERVE
- REVASCULARIZATION
- Computational fluid dynamics
- STENT PLACEMENT
- LONG-TERM OUTCOMES
- FIBROMUSCULAR DYSPLASIA
- ANGIOGRAPHY