Interventions for Renovascular Hypertension View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2016-08-03

AUTHORS

Thomas Zeller , Ulrich Beschorner , Elias Noory

ABSTRACT

Three major clinical symptoms result from significant renal artery stenosis (RAS): arterial hypertension, nephropathy, and destabilizing cardiac syndromes. Main etiologies of RAS are atherosclerosis (approximately 90 %) and fibromuscular dysplasia (FMD). Atherosclerotic RAS has a considerable overlap with atherosclerotic manifestation elsewhere and is associated with an overall poor prognosis. Technical improvements of diagnostic and interventional endovascular tools have led to a more widespread use of transluminal renal artery revascularization and extension of interventional indications during the past three decades. Plain balloon angioplasty is still considered the method of choice for the treatment of FMD, whereas stent implantation is indicated in ostial atherosclerotic RAS. However, despite positive retrospective single center experiences, none of the published randomized controlled trials could prove a benefit of RAS revascularization compared to medical management. These negative trials including the CORAL trial had significant flaws in study design; crucial for a clinical benefit of revascularization of RAS is a proper patient selection, revascularization is only indicated in hemodynamic relevant RAS. This chapter summarizes the epidemiology, indications for treatment, and technical aspects of endovascular treatment of RAS. More... »

PAGES

3-27

Book

TITLE

Interventional Therapies for Secondary and Essential Hypertension

ISBN

978-3-319-34140-8
978-3-319-34141-5

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-3-319-34141-5_1

DOI

http://dx.doi.org/10.1007/978-3-319-34141-5_1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1023568817


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