Long-term cardiovascular outcome after renal revascularization.
(2019) Polskie Archiwum Medycyny Wewnetrznej — Vol. 129, n° 11, p. 735-737 (2019)
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- Abstract
- (en) Percutaneous stenting of the renal artery for the treatment of presumed renovascular hypertension due to atherosclerotic renal artery stenosis (RAS) remains a controversial issue. From dilating and stenting every renal stenosis in the 1990s, the approach changed to conservative therapy following the landmark trials in the field. Indeed, both the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) and ASTRAL (Angioplasty and Stent for Renal Artery Lesions) trials, and some other randomized controlled trials failed to show improvement in blood pressure (BP) control as well as renal function.1 However, all these trials have been criticized for lack of power, nonstandardized inclusion criteria, also with the inclusion of patients with only mild stenosis, and inadequate selection of patients that led to the exclusion of high-risk individuals.1,2 On the other hand, clinical experience and observational studies do show a beneficial effect of revascularization on BP, renal function, and even cardiovascular (CV) events in patients with progressive but reversible renal failure, resistant or refractory hypertension, or circulatory fluid overload. [...]
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Van der Niepen, P., & Persu, A. (2019). Long-term cardiovascular outcome after renal revascularization. Polskie Archiwum Medycyny Wewnetrznej, 129(11), 735-737. https://doi.org/10.20452/pamw.15075 (Original work published 2019)