Renovascular

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Renal artery stenosis resulting in renovascular hypertension or renal ischemia is a potentially treatable condition that results in increased morbidity and mortality, especially among older individuals. Sophisticated imaging techniques are used for screening and identification of affected patients to guide therapy. Treatment guidelines recommend intervention in patients with significant renal artery stenosis, although recent evidence has questioned the benefit of intervention in certain populations. Current research focuses on improving the specificity of imaging techniques and determining which imaging modalities best identify patients who will benefit from intervention...

BACKGROUND: Current trial data may not be directly applicable to patients with the highest risk presentations of atherosclerotic renovascular disease, including flash pulmonary edema, rapidly declining kidney function, and refractory hypertension. We consider the prognostic implications of these presentations and response to percutaneous revascularization. STUDY DESIGN: Single-center prospective cohort study; retrospectively analyzed. SETTING & PARTICIPANTS: 467 patients with renal artery stenosis ≥50%, managed according to clinical presentation and physician/patient preference...

Atherosclerotic renal artery stenoses (aRAS) are often associated with an aorto-iliac type of peripheral occlusive artery disease and may result in deterioration of blood pressure control, chronic kidney disease and myocardial dysfunction. Stenting of aRAS has almost replaced surgical revascularisation. However, the benefit of endovascular treatment of aRAS was challenged by the results of the STAR and ASTRAL trials demonstrating similar outcomes for revascularisation and conservative treatment. Due to severe limitations in trial design, the study results can only be applied to a small proportion of the affected patient population...

Two new recommendations of the European Society of Radiology task force and the European Society of Uroradiology workgroup on paediatric uroradiology are presented. One deals with diagnostic imaging in children after trauma to the urinary tract-renal trauma, in particular. The other concerns the evaluation of suspected renal hypertension. Available data in the paediatric literature are either unsatisfactory or controversial for both of these clinical settings. Therefore, the following consensus-based proposals aim at outlining effective imaging algorithms to reduce invasive imaging procedures while optimising diagnostic accuracy...

The management of renal artery stenosis (RAS) has been the subject of numerous clinical studies and recommendations, most frequently with regards to atherosclerotic RAS. We present the current recommendations from the French Society of Cardiac and Vascular Imaging updated from a recent literature review (April 2008) with regards to medical, endovascular and surgical management of atheroscletotic and non-atherosclerotic RAS. The evidence-based recommendations are ranked by level.

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There is little debate that an untreated significant obstruction of blood flow to the kidney, most often due to atherosclerosis, is potentially hazardous to the health of patients. The treatment of atherosclerotic renovascular disease has evolved over the past 20 years from open surgery with its inherent morbidity and risk of mortality to percutaneous endovascular treatment with stents. The current debate is on the question of which patients are offered any additional advantage by revascularization for renal artery stenosis over medications alone...

PURPOSE: To examine the positive reporting bias regarding the link with gadolinium (Gd) exposure and nephrogenic systemic fibrosis (NSF) in patients with renal impairment. This link has impacted strongly the international radiology safety guidelines. We believe that positive reporting bias has prevailed in the literature and that very few patients with a glomerular filtration rate (GFR) 15-29 mL/min (stage 4 chronic kidney disease [CKD]) should be regarded as high risk. MATERIALS AND METHODS: To examine this, we conducted the following steps: 1...

BACKGROUND: It is uncertain whether patients with renal vascular disease will have renal or mortality benefit from re-establishing renal blood flow with renal revascularization procedures. The RAVE study will compare renal revascularization to medical management for people with atherosclerotic renal vascular disease (ARVD) and the indication for revascularization. Patients will be assessed for the standard nephrology research outcomes of progression to doubling of creatinine, need for dialysis, and death, as well as other cardiovascular outcomes...

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Atherosclerotic renal artery stenosis accounts for most cases of renovascular hypertension (RVH). Hypertensive patients with clinical features suggesting RVH should be submitted to further noninvasive evaluation including duplex Doppler ultrasonography, CT- or MR angiography. Invasive evaluation by contrast-enhanced angiography confirms the diagnosis of renal artery stenosis. However, neither diagnostic test reliably predicts the course of hypertension after revascularisation. The therapeutic approach in hypertensive patients with hemodynamically important renal artery stenosis includes medical or invasive therapy (renal percutaneous transluminal angioplasty, PTRA; renal arterial stent placement, PTRAS; surgical revascularisation)...

No abstract text is available yet for this article.