Author + information
- Received July 18, 2008
- Revision received September 29, 2008
- Accepted October 10, 2008
- Published online March 1, 2009.
- Robert D. Safian, MD, FACC⁎ ( and )
- Ryan D. Madder, MD
- ↵⁎Reprint requests and correspondence:
Dr. Robert D. Safian, Director, Cardiac and Vascular Intervention, Department of Cardiovascular Medicine, William Beaumont Hospital, Heart Center-3rd Floor, 3601 W. Thirteen Mile Road, Royal Oak, Michigan 48073
Renal artery stenosis (RAS) is caused by a heterogenous group of diseases with different pathophysiology, clinical manifestations, treatment approaches, and outcomes. The 2 most common forms of RAS are fibromuscular dysplasia (FMD) and atherosclerosis (ARAS). Renovascular syndromes are broadly classified into renovascular hypertension and ischemic nephropathy, but these terms are misleading, because they imply a causal relationship between RAS, hypertension, and renal dysfunction, which is difficult to prove in humans. Data supporting renal revascularization are limited by heterogeneous causes of hypertension and renal dysfunction, insufficient understanding of the relationship between RAS and nephropathy, inconsistent techniques for revascularization, ambiguous terminology and end points to assess benefit, and lack of large-scale randomized trials. The purpose of this review is to enhance understanding of the epidemiology, clinical markers, and diagnosis of RAS; the relationship between RAS and important disease states; the distinction between renal ischemia and nephropathy; optimal revascularization techniques; and avoidance of renal injury.
- Received July 18, 2008.
- Revision received September 29, 2008.
- Accepted October 10, 2008.
- American College of Cardiology Foundation
- Epidemiology of RAS
- Clinical Manifestations of RAS
- Assessment of RAS and Its Clinical Significance
- Relationship Between RAS and Renal Dysfunction
- Renal Artery Revascularization: Technical Considerations
- Outcomes After Renal Artery Revascularization
- Approach to Specific Clinical Situations