Renal artery stenosis

To intervene, or not to intervene, "that is the question"

Syed S. Haqqie, Anthony Nappi, Gary Siskin, Nouman A. Syed, Ketan Ghate, Roy O. Mathew, Jeffrey Wang, Mandeep S. Sidhu, Vishesh Kumar, Loay Salman, Donna Merrill, Muhammad Ut Akmal, Ali Nayer, Arif Asif

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Renal artery stenosis (RAS) due to atherosclerosis continues to be a major cause of secondary hypertension. It can also lead to renal dysfunction due to ischemic nephropathy. While major clinical trials have emphasized that medical management should be preferred over angioplasty and stenting for the treatment of renal artery stenosis, clinical scenarios continue to raise doubts about the optimal management strategy. Herein, we present two cases that were admitted with hypertensive emergency and renal function deterioration. Medical therapy failed to control the blood pressure and in one patient, renal failure progressed to a point where renal replacement therapy was required. Both patients underwent angioplasty (for >90% stenosis) and stent insertion with successful resolution of stenosis by interventional radiology. Postoperatively, blood pressure gradually decreased with improvement in serum creatinine. Dialysis therapy was discontinued. At 4- and 8-month follow-up, both patients continue to do well with blood pressure readings in the 132-145/70-90 mmHg range. This article highlights the importance of percutaneous interventions in the management of atherosclerotic RAS and calls for heightened awareness and careful identification of candidates who would benefit from angioplasty and stent insertion.

Original languageEnglish
JournalSeminars in Dialysis
Volume27
Issue number1
DOIs
StatePublished - Jan 1 2014

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Renal Artery Obstruction
Angioplasty
Blood Pressure
Stents
Pathologic Constriction
Kidney
Interventional Radiology
Renal Replacement Therapy
Renal Insufficiency
Reading
Dialysis
Creatinine
Atherosclerosis
Emergencies
Therapeutics
Clinical Trials
Hypertension
Serum

ASJC Scopus subject areas

  • Nephrology

Cite this

Haqqie, S. S., Nappi, A., Siskin, G., Syed, N. A., Ghate, K., Mathew, R. O., ... Asif, A. (2014). Renal artery stenosis: To intervene, or not to intervene, "that is the question". Seminars in Dialysis, 27(1). https://doi.org/10.1111/sdi.12140

Renal artery stenosis : To intervene, or not to intervene, "that is the question". / Haqqie, Syed S.; Nappi, Anthony; Siskin, Gary; Syed, Nouman A.; Ghate, Ketan; Mathew, Roy O.; Wang, Jeffrey; Sidhu, Mandeep S.; Kumar, Vishesh; Salman, Loay; Merrill, Donna; Akmal, Muhammad Ut; Nayer, Ali; Asif, Arif.

In: Seminars in Dialysis, Vol. 27, No. 1, 01.01.2014.

Research output: Contribution to journalArticle

Haqqie, SS, Nappi, A, Siskin, G, Syed, NA, Ghate, K, Mathew, RO, Wang, J, Sidhu, MS, Kumar, V, Salman, L, Merrill, D, Akmal, MU, Nayer, A & Asif, A 2014, 'Renal artery stenosis: To intervene, or not to intervene, "that is the question"', Seminars in Dialysis, vol. 27, no. 1. https://doi.org/10.1111/sdi.12140
Haqqie, Syed S. ; Nappi, Anthony ; Siskin, Gary ; Syed, Nouman A. ; Ghate, Ketan ; Mathew, Roy O. ; Wang, Jeffrey ; Sidhu, Mandeep S. ; Kumar, Vishesh ; Salman, Loay ; Merrill, Donna ; Akmal, Muhammad Ut ; Nayer, Ali ; Asif, Arif. / Renal artery stenosis : To intervene, or not to intervene, "that is the question". In: Seminars in Dialysis. 2014 ; Vol. 27, No. 1.
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