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Renal Artery Stenosis—When To Screen, What To Stent?
Renal artery stensosis (RAS) continues to be a problem for clinicians, with no clear consensus on how to investigate and assess the clinical significance of stenotic lesions and manage the findings. RAS caused by fibromuscular dysplasia is probably commoner than previously appreciated, should be act...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer US
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010717/ https://www.ncbi.nlm.nih.gov/pubmed/24743868 http://dx.doi.org/10.1007/s11883-014-0416-2 |
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author | Jennings, Claudine G. Houston, John G. Severn, Alison Bell, Samira Mackenzie, Isla S. MacDonald, Thomas M. |
author_facet | Jennings, Claudine G. Houston, John G. Severn, Alison Bell, Samira Mackenzie, Isla S. MacDonald, Thomas M. |
author_sort | Jennings, Claudine G. |
collection | PubMed |
description | Renal artery stensosis (RAS) continues to be a problem for clinicians, with no clear consensus on how to investigate and assess the clinical significance of stenotic lesions and manage the findings. RAS caused by fibromuscular dysplasia is probably commoner than previously appreciated, should be actively looked for in younger hypertensive patients and can be managed successfully with angioplasty. Atheromatous RAS is associated with increased incidence of cardiovascular events and increased cardiovascular mortality, and is likely to be seen with increasing frequency. Evidence from large clinical trials has led clinicians away from recommending interventional revascularisation towards aggressive medical management. There is now interest in looking more closely at patient selection for intervention, with focus on intervening only in patients with the highest-risk presentations such as flash pulmonary oedema, rapidly declining renal function and severe resistant hypertension. The potential benefits in terms of improving hard cardiovascular outcomes may outweigh the risks of intervention in this group, and further research is needed. |
format | Online Article Text |
id | pubmed-4010717 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-40107172014-05-07 Renal Artery Stenosis—When To Screen, What To Stent? Jennings, Claudine G. Houston, John G. Severn, Alison Bell, Samira Mackenzie, Isla S. MacDonald, Thomas M. Curr Atheroscler Rep Cardiovascular Disease and Stroke (P Perrone-Filardi and S. Agewall, Section Editors) Renal artery stensosis (RAS) continues to be a problem for clinicians, with no clear consensus on how to investigate and assess the clinical significance of stenotic lesions and manage the findings. RAS caused by fibromuscular dysplasia is probably commoner than previously appreciated, should be actively looked for in younger hypertensive patients and can be managed successfully with angioplasty. Atheromatous RAS is associated with increased incidence of cardiovascular events and increased cardiovascular mortality, and is likely to be seen with increasing frequency. Evidence from large clinical trials has led clinicians away from recommending interventional revascularisation towards aggressive medical management. There is now interest in looking more closely at patient selection for intervention, with focus on intervening only in patients with the highest-risk presentations such as flash pulmonary oedema, rapidly declining renal function and severe resistant hypertension. The potential benefits in terms of improving hard cardiovascular outcomes may outweigh the risks of intervention in this group, and further research is needed. Springer US 2014-04-18 2014 /pmc/articles/PMC4010717/ /pubmed/24743868 http://dx.doi.org/10.1007/s11883-014-0416-2 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Cardiovascular Disease and Stroke (P Perrone-Filardi and S. Agewall, Section Editors) Jennings, Claudine G. Houston, John G. Severn, Alison Bell, Samira Mackenzie, Isla S. MacDonald, Thomas M. Renal Artery Stenosis—When To Screen, What To Stent? |
title | Renal Artery Stenosis—When To Screen, What To Stent? |
title_full | Renal Artery Stenosis—When To Screen, What To Stent? |
title_fullStr | Renal Artery Stenosis—When To Screen, What To Stent? |
title_full_unstemmed | Renal Artery Stenosis—When To Screen, What To Stent? |
title_short | Renal Artery Stenosis—When To Screen, What To Stent? |
title_sort | renal artery stenosis—when to screen, what to stent? |
topic | Cardiovascular Disease and Stroke (P Perrone-Filardi and S. Agewall, Section Editors) |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4010717/ https://www.ncbi.nlm.nih.gov/pubmed/24743868 http://dx.doi.org/10.1007/s11883-014-0416-2 |
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