Journal Title
Title of Journal: Curr Treat Options Cardio Med
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Abbravation: Current Treatment Options in Cardiovascular Medicine
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Authors: Paul J O’Connor Robert A Lookstein
Publish Date: 2016/06/08
Volume: 18, Issue: 8, Pages: 48-
Abstract
Atherosclerotic renal artery stenosis RAS is highly associated with hypertension and renal insufficiency Determining causation and who may benefit from RAS treatment remains difficult The role of endovascular management of atherosclerotic RAS was challenged by several recent randomized controlled trials RCT which failed to demonstrate benefit of stenting In the largest RCT to date the Cardiovascular Outcomes in Renal Atherosclerotic Lesions CORAL study did not find benefit of revascularization compared to medical therapy alone While such RCTs represent the highest level of evidence to date the conclusions drawn from them should be interpreted with caution due to substantial flaws in study design inclusion and exclusion criteria The current AHA/ACC recommendations for RAS management are supported by many levelII evidence cohort studies which consistently found benefit of revascularization in groups with the highest likelihood of clinically significant RAS Further study of these patient groups are needed to define a clear role for endovascular therapy of renal artery stenosis
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