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PERIPHERAL ARTERIES  HANDLING OF AORTIC AND PERIPHERAL ARTERIAL PATHOLOGIES 

The Journal of Cardiovascular Surgery 2017 April;58(2):329-38

DOI: 10.23736/S0021-9509.16.09827-X

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

How to manage hypertension with atherosclerotic renal artery stenosis?

Jean-Baptiste, RICCO 1, Romain BELMONTE 1, Guilio ILLUMINATI 2, Xavier BARRAL 3, Fabrice SCHNEIDER 1, Bertrand CHAVENT 3

1 Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France; 2 F. Durante Department of Surgical Sciences, La Sapienza University, Rome, Italy; 3 Department of Vascular Surgery, University Hospital of Saint-Etienne, Saint-Etienne, France


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The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS.


KEY WORDS: Renal insufficiency, chronic - Hypertension - Renal artery obstruction

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