Renal artery stenosis (trial of angioplasty vs. medical)

Renal artery stenosis is associated with hypertension in humans and laboratory animals. Patients with atherosclerotic renal artery stenosis and hypertension are commonly treated by transluminal renal artery angioplasty.

• a systematic review investigating the management strategies for renal artery stenosis has been undertaken (1):
  • weak evidence suggested no large differences in mortality rates or cardiovascular events between medical and revascularization treatments. Acceptable evidence suggested similar kidney-related outcomes but better blood pressure outcomes with angioplasty, particularly in patients with bilateral disease. Improvements in kidney function and cure of hypertension were reported among some patients only in cohort studies of angioplasty. Evidence from direct comparisons of interventions is sparse and inadequate to draw robust conclusions
  • evidence does not clearly support one treatment approach over another for atherosclerotic renal artery stenosis

Reference:

1. Balk E et al. Effectiveness of management strategies for renal artery stenosis: a systematic review. Ann Intern Med. 2006 Dec 19;145(12):901-12