Pitfalls in Imaging for Renal Artery Stenosis
Authors: Stephen C. Textor
Journal: Annals of Internal Medicine (2004)

Editorials2 November 2004Pitfalls in Imaging for Renal Artery StenosisStephen C. Textor, MDStephen C. Textor, MDFrom Mayo Clinic, Rochester, MN 55905.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-9-200411020-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Renal artery stenosis is recognized as an important cause of secondary hypertension. Particularly with atherosclerotic disease, renal artery stenosis can progress to threaten kidney function and complicate congestive heart failure. Management of this disorder requires a balance of both careful medical intervention and well-timed renal revascularization.Some degree of renovascular disease is remarkably common. Community-based studies indicate that renal artery stenosis is more prevalent with advancing age; in one study, 6.8% of a general population older than 65 years of age had renal artery lesions of more than 60% occlusion (1). When aortography of the renal arteries is performed during ...References1. Hansen KJ, Edwards MS, Craven TE, Cherr GS, Jackson SA, Appel RG, et al . Prevalence of renovascular disease in the elderly: a population-based study. J Vasc Surg. 2002;36:443-51. [PMID: 12218965] CrossrefMedlineGoogle Scholar2. Rihal CS, Textor SC, Breen JF, McKusick MA, Grill DE, Hallett JW, et al . Incidental renal artery stenosis among a prospective cohort of hypertensive patients undergoing coronary angiography. Mayo Clin Proc. 2002;77:309-16. [PMID: 11936924] CrossrefMedlineGoogle Scholar3. Scoble JE. The epidemiology and clinical manifestations of atherosclerotic renal disease.. In: Novick AC, Scoble J, Hamilton G, eds. Renal Vascular Disease. London: WB Saunders; 1996:303-14. Google Scholar4. Vasbinder GB, Nelemans PJ, Kessels AG, Kroon AA, Maki JH, Leiner T, et al . Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis. Ann Intern Med. 2004;141:674-82. LinkGoogle Scholar5. Textor SC. Renovascular hypertension and ischemic nephropathy.. In: Brenner BM, eds. Brenner and Rector's The Kidney. 7th ed. Philadelphia: Saunders; 2004:2065-108. Google Scholar6. Radermacher J, Weinkove R, Haller H. Techniques for predicting a favourable response to renal angioplasty in patients with renovascular disease. Curr Opin Nephrol Hypertens. 2001;10:799-805. [PMID: 11706308] CrossrefMedlineGoogle Scholar7. Textor SC. Managing renal arterial disease and hypertension. Curr Opin Cardiol. 2003;18:260-7. [PMID: 12858123] CrossrefMedlineGoogle Scholar8. Caps MT, Perissinotto C, Zierler RE, Polissar NL, Bergelin RO, Tullis MJ, et al . Prospective study of atherosclerotic disease progression in the renal artery. Circulation. 1998;98:2866-72. [PMID: 9860789] CrossrefMedlineGoogle Scholar9. Plouin PF, Chatellier G, Darne B, Raynaud A. Blood pressure outcome of angioplasty in atherosclerotic renal artery stenosis: a randomized trial. Essai Multicentrique Medicaments vs Angioplastie (EMMA) Study Group. Hypertension. 1998;31:823-9. [PMID: 9495267] CrossrefMedlineGoogle Scholar10. van Jaarsveld BC, Krijnen P, Pieterman H, Derkx FH, Deinum J, Postma CT, et al . The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Engl J Med. 2000;342:1007-14. [PMID: 10749962] CrossrefMedlineGoogle Scholar11. Webster J, Marshall F, Abdalla M, Dominiczak A, Edwards R, Isles CG, et al . Randomised comparison of percutaneous angioplasty vs continued medical therapy for hypertensive patients with atheromatous renal artery stenosis. Scottish and Newcastle Renal Artery Stenosis Collaborative Group. J Hum Hypertens. 1998;12:329-35. [PMID: 9655655] CrossrefMedlineGoogle Scholar12. Plouin PF. Stable patients with atherosclerotic renal artery stenosis should be treated first with medical management. Am J Kidney Dis. 2003;42:851-7. [PMID: 14582030] CrossrefMedlineGoogle Scholar13. Vasbinder GB, Nelemans PJ, Kessels AG, Kroon AA, de Leeuw PW, van Engelshoven JM. Diagnostic tests for renal artery stenosis in patients suspected of having renovascular hypertension: a meta-analysis. Ann Intern Med. 2001;135:401-11. [PMID: 11560453] LinkGoogle Scholar14. Isles CG, Robertson S, Hill D. Management of renovascular disease: a review of renal artery stenting in ten studies. QJM. 1999;92:159-67. [PMID: 10326075] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Mayo Clinic, Rochester, MN 55905.Disclosures: None disclosed.Corresponding Author: Stephen C. Textor, MD, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905; e-mail, textor.[email protected]edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAccuracy of Computed Tomographic Angiography and Magnetic Resonance Angiography for Diagnosing Renal Artery Stenosis G. Boudewijn C. Vasbinder , Patricia J. Nelemans , Alfons G.H. Kessels , Abraham A. Kroon , Jeffrey H. Maki , Tim Leiner , Frederik J.A. Beek , Michael B.J.M. Korst , Karin Flobbe , Michiel W. de Haan , Willem H. van Zwam , Cornelis T. Postma , M. G. Myriam Hunink , Peter W. de Leeuw , Jos M.A. van Engelshoven , and Metrics Cited ByRenovascular HypertensionHypertension Canada's 2017 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in AdultsAtherosclerotic Renal Artery StenosisGenitourinary SystemEndovascular Treatment of Renal Artery StenosisNefropatia isquêmicaDiagnostic criteria for renovascular disease: where are we now?Non-enhanced MR angiography of renal artery using inflow-sensitive inversion recovery pulse sequence: A prospective comparison with enhanced CT angiographyRenovascular Hypertension and Ischemic NephropathyApproach to New-Onset Hypertension Remote from TermScreening tests for diagnosis of renal artery stenosisTecniche diagnostiche per lo studio dell'apparato nefro-urinarioCurrent Approaches to Renovascular HypertensionPathophysiology and Evaluation of Renovascular HypertensionImaging in adult nephrologyRenovascular hypertension in 2007: Where are we now?Renovascular hypertension updateRenovascular disease imaging: Today more than ever the invasive cardiologist may make the differenceAssessing the appropriateness and increasing the yield of renal angiography in patients undergoing coronary angiography: a scoring systemRenovascular disease in patients with coronary artery diseaseRenovascular Hypertension and Ischemic NephropathyAtherosclerotic renovascular disease in chronic heart failure: should we intervene?Basis of Renal Scintigraphy 2 November 2004Volume 141, Issue 9Page: 730-731KeywordsAngiographyDiagnostic imagingHypertensionKidneysLesionsMagnetic resonance angiographyRenal arteriesRenal diseasesRevascularizationStenosis ePublished: 2 November 2004 Issue Published: 2 November 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...