Renal artery stenting in the correct patients with atherosclerotic renovascular disease: time for a proper renal and cardiovascular outcome study?
Theodorakopoulou, Marieta P Karagiannidis, Artemios G Ferro, Charles J Ortiz, Alberto Sarafidis, Pantelis A
Theodorakopoulou, Marieta P
Karagiannidis, Artemios G
Ferro, Charles J
Ortiz, Alberto
Sarafidis, Pantelis A
Abstract
Atherosclerotic renovascular disease (ARVD) represents the most common type of renal artery stenosis. In the last decade, a few large trials failed to demonstrate the superiority of standard medical therapy plus percutaneous transluminal renal angioplasty (PTRA) compared with medical therapy alone in lowering blood pressure levels or preventing adverse renal and cardiovascular outcomes in patients with ARVD. However, this issue remains controversial and an ongoing debate focusses on the benefits that selected patients could experience from renal revascularization procedures. In this regard, several pieces of observational data show that PTRA is associated with future cardiorenal benefits in patients presenting with high-risk ARVD phenotypes. Such evidence resulted in a progressive shift in relevant recommendations, with most recent not-graded suggestions supporting that revascularization should be offered in these high-risk subjects. Existing evidence clearly calls for a properly designed randomized controlled trial with selected patients presenting high-risk ARVD phenotypes, in order to confirm the superiority of PTRA versus non-invasive management in this patient group and objectively guide everyday clinical practice.
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Date
2022-05-12
Type
Article
Subject
Collections
Citation
Theodorakopoulou MP, Karagiannidis AG, Ferro CJ, Ortiz A, Sarafidis PA. Renal artery stenting in the correct patients with atherosclerotic renovascular disease: time for a proper renal and cardiovascular outcome study? Clin Kidney J. 2022 May 12;16(2):201-204. doi: 10.1093/ckj/sfac140
Journal / Source Title
Clinical Kidney Journal
DOI
10.1093/ckj/sfac140
PMID
36755839
Publisher
Oxford University Press
Publisher’s URL
https://academic.oup.com/ckj