Endovaskuläre Therapie der Nierenarterienstenose (NAST) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-04-01

AUTHORS

T. Zeller

ABSTRACT

BackgroundAtherosclerotic renal artery stenoses (RAS) are often associated with an aortoiliac type of peripheral occlusive artery disease and may result in deterioration of blood pressure control, renal and myocardial dysfunction. Stenting of RAS has almost replaced surgical revascularization; however, the clinical benefit of endovascular treatment of RAS was challenged by the results of recent randomized controlled trials (STAR, ASTRAL and CORAL) demonstrating similar outcomes for revascularization and conservative treatment.AimThis review summarizes the current knowledge about the clinical presentation and the endovascular treatment of RAS and critically discusses the currently published evidence.MethodsRelevant publications on the specific topic of endovascular treatment of RAS were identified in a PubMed database search and are discussed in the light of own clinical scientific experience.ResultsDue to severe limitations in trial design and high patient selection, the published randomized controlled study results, which are considered as level 1 evidence, can only be applied to a small proportion of the affected patient population. The clinical benefit of renal stenting is only likely if the indications for revascularization were correct, in particular if the hemodynamic relevance of the lesion was verified by either duplex ultrasound or pressure gradient measurement. Clinical predictors for treatment success, such as pulse pressure < 50 ± 10 mmHg, high diastolic blood pressure, elevated brain natriuretic peptide (BNP) levels and renal insufficiency are often not sufficiently considered in the decision-making process. Unquestioned by international guidelines are the indications for revascularization of atherosclerotic RAS of a single functioning kidney, severe bilateral lesions, resistant hypertension, deterioration of renal function and in every kind of significant RAS of a non-atherosclerotic nature.ConclusionUnder the condition of an appropriate patient selection, endovascular therapy of RAS results in clinical improvements. Studies with appropriate design and methodology are still lacking. More... »

PAGES

119-126

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00772-015-0004-y

DOI

http://dx.doi.org/10.1007/s00772-015-0004-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046234329


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1103", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Clinical Sciences", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "Abteilung Angiologie, Klinik f\u00fcr Kardiologie und Angiologie II, Universit\u00e4ts-Herzzentrum Freiburg \u2013 Bad Krozingen, S\u00fcdring 15, 79189, Bad Krozingen, Deutschland", 
          "id": "http://www.grid.ac/institutes/grid.418466.9", 
          "name": [
            "Abteilung Angiologie, Klinik f\u00fcr Kardiologie und Angiologie II, Universit\u00e4ts-Herzzentrum Freiburg \u2013 Bad Krozingen, S\u00fcdring 15, 79189, Bad Krozingen, Deutschland"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Zeller", 
        "givenName": "T.", 
        "id": "sg:person.01306206724.74", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01306206724.74"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "sg:pub.10.1038/sj.jhh.1000599", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1018663291", 
          "https://doi.org/10.1038/sj.jhh.1000599"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2015-04-01", 
    "datePublishedReg": "2015-04-01", 
    "description": "BackgroundAtherosclerotic renal artery stenoses (RAS) are often associated with an aortoiliac type of peripheral occlusive artery disease and may result in deterioration of blood pressure control, renal and myocardial dysfunction. Stenting of RAS has almost replaced surgical revascularization; however, the clinical benefit of endovascular treatment of RAS was challenged by the results of recent randomized controlled trials (STAR, ASTRAL and CORAL) demonstrating similar outcomes for revascularization and conservative treatment.AimThis review summarizes the current knowledge about the clinical presentation and the endovascular treatment of RAS and critically discusses the currently published evidence.MethodsRelevant publications on the specific topic of endovascular treatment of RAS were identified in a PubMed database search and are discussed in the light of own clinical scientific experience.ResultsDue to severe limitations in trial design and high patient selection, the published randomized controlled study results, which are considered as level 1 evidence, can only be applied to a small proportion of the affected patient population. The clinical benefit of renal stenting is only likely if the indications for revascularization were correct, in particular if the hemodynamic relevance of the lesion was verified by either duplex ultrasound or pressure gradient measurement. Clinical predictors for treatment success, such as pulse pressure <\u200950\u2009\u00b1\u200910\u00a0mmHg, high diastolic blood pressure, elevated brain natriuretic peptide (BNP) levels and renal insufficiency are often not sufficiently considered in the decision-making process. Unquestioned by international guidelines are the indications for revascularization of atherosclerotic RAS of a single functioning kidney, severe bilateral lesions, resistant hypertension, deterioration of renal function and in every kind of significant RAS of a non-atherosclerotic nature.ConclusionUnder the condition of an appropriate patient selection, endovascular therapy of RAS results in clinical improvements. Studies with appropriate design and methodology are still lacking.", 
    "genre": "article", 
    "id": "sg:pub.10.1007/s00772-015-0004-y", 
    "inLanguage": "en", 
    "isAccessibleForFree": false, 
    "isPartOf": [
      {
        "id": "sg:journal.1115494", 
        "issn": [
          "0948-7034", 
          "1434-3932"
        ], 
        "name": "Gef\u00e4sschirurgie", 
        "publisher": "Springer Nature", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "2", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "20"
      }
    ], 
    "keywords": [
      "renal artery stenosis", 
      "endovascular treatment", 
      "patient selection", 
      "clinical benefit", 
      "elevated brain natriuretic peptide levels", 
      "peripheral occlusive artery disease", 
      "brain natriuretic peptide levels", 
      "atherosclerotic renal artery stenosis", 
      "higher diastolic blood pressure", 
      "significant renal artery stenosis", 
      "occlusive artery disease", 
      "single functioning kidney", 
      "severe bilateral lesions", 
      "natriuretic peptide levels", 
      "blood pressure control", 
      "level 1 evidence", 
      "diastolic blood pressure", 
      "appropriate patient selection", 
      "affected patient population", 
      "PubMed database search", 
      "pressure gradient measurement", 
      "surgical revascularization", 
      "MethodsRelevant publications", 
      "Endovaskul\u00e4re Therapie", 
      "renal stenting", 
      "renal insufficiency", 
      "resistant hypertension", 
      "conservative treatment", 
      "renal function", 
      "clinical improvement", 
      "artery disease", 
      "clinical predictors", 
      "blood pressure", 
      "functioning kidney", 
      "endovascular therapy", 
      "artery stenosis", 
      "myocardial dysfunction", 
      "clinical presentation", 
      "duplex ultrasound", 
      "patient population", 
      "pulse pressure", 
      "hemodynamic relevance", 
      "treatment success", 
      "bilateral lesions", 
      "peptide levels", 
      "revascularization", 
      "trial design", 
      "international guidelines", 
      "pressure control", 
      "similar outcomes", 
      "treatment", 
      "lesions", 
      "database search", 
      "current knowledge", 
      "small proportion", 
      "indications", 
      "hypertension", 
      "stenting", 
      "stenosis", 
      "Therapie", 
      "dysfunction", 
      "study results", 
      "mmHg", 
      "therapy", 
      "insufficiency", 
      "kidney", 
      "disease", 
      "RAS results", 
      "trials", 
      "deterioration", 
      "evidence", 
      "ultrasound", 
      "outcomes", 
      "predictors", 
      "presentation", 
      "benefits", 
      "guidelines", 
      "ConclusionUnder", 
      "review", 
      "population", 
      "pressure", 
      "proportion", 
      "decision-making process", 
      "levels", 
      "control", 
      "study", 
      "results", 
      "relevance", 
      "severe limitations", 
      "gradient measurements", 
      "improvement", 
      "experience", 
      "search", 
      "function", 
      "publications", 
      "knowledge", 
      "specific topics", 
      "types", 
      "success", 
      "selection", 
      "limitations", 
      "scientific experience", 
      "conditions", 
      "design", 
      "measurements", 
      "appropriate design", 
      "topic", 
      "light", 
      "nature", 
      "process", 
      "methodology", 
      "kind"
    ], 
    "name": "Endovaskul\u00e4re Therapie der Nierenarterienstenose (NAST)", 
    "pagination": "119-126", 
    "productId": [
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1046234329"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1007/s00772-015-0004-y"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1007/s00772-015-0004-y", 
      "https://app.dimensions.ai/details/publication/pub.1046234329"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2022-05-10T10:12", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-springernature-scigraph/baseset/20220509/entities/gbq_results/article/article_674.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "https://doi.org/10.1007/s00772-015-0004-y"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s00772-015-0004-y'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s00772-015-0004-y'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s00772-015-0004-y'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00772-015-0004-y'


 

This table displays all metadata directly associated to this object as RDF triples.

174 TRIPLES      22 PREDICATES      138 URIs      129 LITERALS      6 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1007/s00772-015-0004-y schema:about anzsrc-for:11
2 anzsrc-for:1103
3 schema:author N9b2c5e47fc1c4cce80832c2c64ed975a
4 schema:citation sg:pub.10.1038/sj.jhh.1000599
5 schema:datePublished 2015-04-01
6 schema:datePublishedReg 2015-04-01
7 schema:description BackgroundAtherosclerotic renal artery stenoses (RAS) are often associated with an aortoiliac type of peripheral occlusive artery disease and may result in deterioration of blood pressure control, renal and myocardial dysfunction. Stenting of RAS has almost replaced surgical revascularization; however, the clinical benefit of endovascular treatment of RAS was challenged by the results of recent randomized controlled trials (STAR, ASTRAL and CORAL) demonstrating similar outcomes for revascularization and conservative treatment.AimThis review summarizes the current knowledge about the clinical presentation and the endovascular treatment of RAS and critically discusses the currently published evidence.MethodsRelevant publications on the specific topic of endovascular treatment of RAS were identified in a PubMed database search and are discussed in the light of own clinical scientific experience.ResultsDue to severe limitations in trial design and high patient selection, the published randomized controlled study results, which are considered as level 1 evidence, can only be applied to a small proportion of the affected patient population. The clinical benefit of renal stenting is only likely if the indications for revascularization were correct, in particular if the hemodynamic relevance of the lesion was verified by either duplex ultrasound or pressure gradient measurement. Clinical predictors for treatment success, such as pulse pressure < 50 ± 10 mmHg, high diastolic blood pressure, elevated brain natriuretic peptide (BNP) levels and renal insufficiency are often not sufficiently considered in the decision-making process. Unquestioned by international guidelines are the indications for revascularization of atherosclerotic RAS of a single functioning kidney, severe bilateral lesions, resistant hypertension, deterioration of renal function and in every kind of significant RAS of a non-atherosclerotic nature.ConclusionUnder the condition of an appropriate patient selection, endovascular therapy of RAS results in clinical improvements. Studies with appropriate design and methodology are still lacking.
8 schema:genre article
9 schema:inLanguage en
10 schema:isAccessibleForFree false
11 schema:isPartOf Na8487912cb184e73a5e50d5ab3b13622
12 Ncac0ebf771554ab08e58a6d8f21cbdeb
13 sg:journal.1115494
14 schema:keywords ConclusionUnder
15 Endovaskuläre Therapie
16 MethodsRelevant publications
17 PubMed database search
18 RAS results
19 Therapie
20 affected patient population
21 appropriate design
22 appropriate patient selection
23 artery disease
24 artery stenosis
25 atherosclerotic renal artery stenosis
26 benefits
27 bilateral lesions
28 blood pressure
29 blood pressure control
30 brain natriuretic peptide levels
31 clinical benefit
32 clinical improvement
33 clinical predictors
34 clinical presentation
35 conditions
36 conservative treatment
37 control
38 current knowledge
39 database search
40 decision-making process
41 design
42 deterioration
43 diastolic blood pressure
44 disease
45 duplex ultrasound
46 dysfunction
47 elevated brain natriuretic peptide levels
48 endovascular therapy
49 endovascular treatment
50 evidence
51 experience
52 function
53 functioning kidney
54 gradient measurements
55 guidelines
56 hemodynamic relevance
57 higher diastolic blood pressure
58 hypertension
59 improvement
60 indications
61 insufficiency
62 international guidelines
63 kidney
64 kind
65 knowledge
66 lesions
67 level 1 evidence
68 levels
69 light
70 limitations
71 measurements
72 methodology
73 mmHg
74 myocardial dysfunction
75 natriuretic peptide levels
76 nature
77 occlusive artery disease
78 outcomes
79 patient population
80 patient selection
81 peptide levels
82 peripheral occlusive artery disease
83 population
84 predictors
85 presentation
86 pressure
87 pressure control
88 pressure gradient measurement
89 process
90 proportion
91 publications
92 pulse pressure
93 relevance
94 renal artery stenosis
95 renal function
96 renal insufficiency
97 renal stenting
98 resistant hypertension
99 results
100 revascularization
101 review
102 scientific experience
103 search
104 selection
105 severe bilateral lesions
106 severe limitations
107 significant renal artery stenosis
108 similar outcomes
109 single functioning kidney
110 small proportion
111 specific topics
112 stenosis
113 stenting
114 study
115 study results
116 success
117 surgical revascularization
118 therapy
119 topic
120 treatment
121 treatment success
122 trial design
123 trials
124 types
125 ultrasound
126 schema:name Endovaskuläre Therapie der Nierenarterienstenose (NAST)
127 schema:pagination 119-126
128 schema:productId N5f9c1f9da4a04869919df7094d15ad00
129 Nac3a177fad5746a69a90a9eba870ba8a
130 schema:sameAs https://app.dimensions.ai/details/publication/pub.1046234329
131 https://doi.org/10.1007/s00772-015-0004-y
132 schema:sdDatePublished 2022-05-10T10:12
133 schema:sdLicense https://scigraph.springernature.com/explorer/license/
134 schema:sdPublisher Nb03bb271e4b3418aa6f2b8a0bbb3916e
135 schema:url https://doi.org/10.1007/s00772-015-0004-y
136 sgo:license sg:explorer/license/
137 sgo:sdDataset articles
138 rdf:type schema:ScholarlyArticle
139 N5f9c1f9da4a04869919df7094d15ad00 schema:name dimensions_id
140 schema:value pub.1046234329
141 rdf:type schema:PropertyValue
142 N9b2c5e47fc1c4cce80832c2c64ed975a rdf:first sg:person.01306206724.74
143 rdf:rest rdf:nil
144 Na8487912cb184e73a5e50d5ab3b13622 schema:volumeNumber 20
145 rdf:type schema:PublicationVolume
146 Nac3a177fad5746a69a90a9eba870ba8a schema:name doi
147 schema:value 10.1007/s00772-015-0004-y
148 rdf:type schema:PropertyValue
149 Nb03bb271e4b3418aa6f2b8a0bbb3916e schema:name Springer Nature - SN SciGraph project
150 rdf:type schema:Organization
151 Ncac0ebf771554ab08e58a6d8f21cbdeb schema:issueNumber 2
152 rdf:type schema:PublicationIssue
153 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
154 schema:name Medical and Health Sciences
155 rdf:type schema:DefinedTerm
156 anzsrc-for:1103 schema:inDefinedTermSet anzsrc-for:
157 schema:name Clinical Sciences
158 rdf:type schema:DefinedTerm
159 sg:journal.1115494 schema:issn 0948-7034
160 1434-3932
161 schema:name Gefässchirurgie
162 schema:publisher Springer Nature
163 rdf:type schema:Periodical
164 sg:person.01306206724.74 schema:affiliation grid-institutes:grid.418466.9
165 schema:familyName Zeller
166 schema:givenName T.
167 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01306206724.74
168 rdf:type schema:Person
169 sg:pub.10.1038/sj.jhh.1000599 schema:sameAs https://app.dimensions.ai/details/publication/pub.1018663291
170 https://doi.org/10.1038/sj.jhh.1000599
171 rdf:type schema:CreativeWork
172 grid-institutes:grid.418466.9 schema:alternateName Abteilung Angiologie, Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg – Bad Krozingen, Südring 15, 79189, Bad Krozingen, Deutschland
173 schema:name Abteilung Angiologie, Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg – Bad Krozingen, Südring 15, 79189, Bad Krozingen, Deutschland
174 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...