Renal revascularization in resistant hypertension
| Autor: | Aashish Gupta, Jose D. Tafur, Tamunoinemi Bob-Manuel, Marloe Prince |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Drug Resistance Hemodynamics Secondary hypertension Blood Pressure 030204 cardiovascular system & hematology Renal Artery Obstruction Renal artery stenosis Appropriate Use Criteria law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial Refractory Risk Factors law medicine.artery Internal medicine medicine Humans cardiovascular diseases 030212 general & internal medicine Renal artery Antihypertensive Agents Vascular Patency business.industry Endovascular Procedures Guideline medicine.disease Hypertension Renovascular Treatment Outcome Cardiology Stents Cardiology and Cardiovascular Medicine business |
| Zdroj: | Progress in Cardiovascular Diseases. 63:58-63 |
| ISSN: | 0033-0620 |
| Popis: | Renal artery stenosis (RAS) is a common cause of secondary hypertension (HTN) and may lead to resistant (refractory) HTN despite guideline directed medical therapy. Although randomized controlled trials comparing medical therapy to medical therapy and renal artery stenting have shown no benefit with renal artery stenting, according to comparative effectiveness reviews by the Agency for Healthcare Research and Quality, the trials did not enroll patients with the most severe RAS who would be more likely to benefit from renal stenting. Because of limitations of conventional angiography, it is important to assess the hemodynamic severity of moderate (50%-70%) RAS lesions with a hemodynamic measurement. We review techniques to optimize patient selection, to minimize procedural complications, and to facilitate durable patency of renal stenting. We also review the current ACC/AHA Guidelines and SCAI Appropriate Use Criteria as they relate to renal stenting. |
| Databáze: | OpenAIRE |
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