Percutaneous intervention for renovascular disease: rationale and patient selection

被引:9
作者
Fernando, D [1 ]
Garasic, J [1 ]
机构
[1] Massachusetts Gen Hosp, Cardiac Unit, Div Cardiol, Boston, MA 02114 USA
关键词
renovascular disease; magnetic resonance angiography; renal artery stenosis;
D O I
10.1097/01.hco.0000143392.80705.a2
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review The anatomic diagnosis of renovascular disease is increasing in frequency due to the advent of sophisticated non-invasive imaging modalities such as MRA (Magnetic Resonance Angiography) and renal angiography at the time of cardiac catheterization. Despite this fact, the investigation and appropriate management of renovascular disease has remained a controversial topic. This review addresses the clinical syndromes associated with renal artery stenosis (RAS) and the published data guiding appropriate patient selection for revascularization. Recent findings There is a growing literature in support of renal revascularization as an aid in improving anti-hypertensive control, preserving renal function, and easing the management of congestive heart failure. Meanwhile, technological advances have allowed intervention in an expanding pool of eligible patients. One such technology is the atheroembolic protection device, which may soon allow renal salvage in patients with significant baseline renal impairment that were previously denied intervention for fear of worsening renal function. Summary The data reviewed herein helps to identify patients that will benefit from renal revascularization. Large-scale, randomized data further defining the role of renal revascularization and optimal patient selection is still needed.
引用
收藏
页码:582 / 588
页数:7
相关论文
共 29 条
[1]   RENAL-ARTERY ANGIOPLASTY - TECHNICAL RESULTS AND CLINICAL OUTCOME IN 320 PATIENTS [J].
BONELLI, FS ;
MCKUSICK, MA ;
TEXTOR, SC ;
KOS, PB ;
STANSON, AW ;
JOHNSON, CM ;
SHEEDY, PF ;
WELCH, TJ ;
SCHIRGER, A .
MAYO CLINIC PROCEEDINGS, 1995, 70 (11) :1041-1052
[2]   The profile of cardiac patients with renal artery stenosis [J].
Buller, CE ;
Nogareda, JG ;
Ramanathan, K ;
Ricci, DR ;
Djurdjev, O ;
Tinckam, KJ ;
Penn, IM ;
Fox, RS ;
Stevens, LA ;
Duncan, JA ;
Levin, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (09) :1606-1613
[3]   Risk of atrophy in kidneys with atherosclerotic renal artery stenosis [J].
Caps, MT ;
Zierler, RE ;
Polissar, NL ;
Bergelin, RO ;
Beach, KW ;
Cantwell-Gab, K ;
Casadei, A ;
Davidson, RC ;
Strandness, ED .
KIDNEY INTERNATIONAL, 1998, 53 (03) :735-742
[4]   Severity of renal vascular disease predicts mortality in patients undergoing coronary angiography [J].
Conlon, PJ ;
Little, MA ;
Pieper, K ;
Mark, DB .
KIDNEY INTERNATIONAL, 2001, 60 (04) :1490-1497
[5]   FOLLOW-UP OF PRIMARY PALMAZ-SCHATZ STENT PLACEMENT FOR ATHEROSCLEROTIC RENAL-ARTERY STENOSIS [J].
DORROS, G ;
JAFF, M ;
JAIN, A ;
DUFEK, C ;
MATHIAK, L .
AMERICAN JOURNAL OF CARDIOLOGY, 1995, 75 (15) :1051-1055
[6]  
FRAISSINETTE B, 2003, CARDIOVASC INTER RAD, V26, P46
[7]   Clinical benefit of renal artery angioplasty with stenting for the control of recurrent and refractory congestive heart failure [J].
Gray, BH ;
Olin, JW ;
Childs, MB ;
Sullivan, TM ;
Bacharach, JM .
VASCULAR MEDICINE, 2002, 7 (04) :275-279
[8]   Effect of renal-artery stenting on progression of renovascular renal failure [J].
Harden, PN ;
MacLeod, MJ ;
Rodger, RSC ;
Baxter, GM ;
Connell, JMC ;
Dominiczak, AF ;
Junor, BJR ;
Briggs, JD ;
Moss, JG .
LANCET, 1997, 349 (9059) :1133-1136
[9]   Renal angioplasty and stenting with distal protection of the main renal artery in ischemic nephropathy: Early experience [J].
Holden, A ;
Hill, A .
JOURNAL OF VASCULAR SURGERY, 2003, 38 (05) :962-968
[10]   Increased sympathetic nerve activity in renovascular hypertension [J].
Johansson, M ;
Elam, M ;
Rundqvist, B ;
Eisenhofer, G ;
Herlitz, H ;
Lambert, G ;
Friberg, P .
CIRCULATION, 1999, 99 (19) :2537-2542