Renal artery stenosis: Difference between revisions
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imported>Robert Badgett |
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==Treatment== | ==Treatment== | ||
Various treatment options exist and no single therapy is superior to others according to a [[systematic review]].<ref name="pmid17062633">{{cite journal |author=Balk E, Raman G, Chung M, ''et al'' |title=Effectiveness of management strategies for renal artery stenosis: a systematic review |journal=Ann. Intern. Med. |volume=145 |issue=12 |pages=901–12 |year=2006 |month=December |pmid=17062633 |doi= |url=http://www.annals.org/cgi/content/full/145/12/901 |issn=}}</ref> | Various treatment options exist and no single therapy is superior to others according to a [[systematic review]].<ref name="pmid17062633">{{cite journal |author=Balk E, Raman G, Chung M, ''et al'' |title=Effectiveness of management strategies for renal artery stenosis: a systematic review |journal=Ann. Intern. Med. |volume=145 |issue=12 |pages=901–12 |year=2006 |month=December |pmid=17062633 |doi= |url=http://www.annals.org/cgi/content/full/145/12/901 |issn=}}</ref> | ||
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===Surgery=== | ===Surgery=== | ||
Surgical revascularization may benefit patients with serum creatinine above 2.0 mg/dl.<ref name="pmid12009679">{{cite journal |author=Uzzo RG, Novick AC, Goormastic M, Mascha E, Pohl M |title=Medical versus surgical management of atherosclerotic renal artery stenosis |journal=Transplant. Proc. |volume=34 |issue=2 |pages=723–5 |year=2002 |month=March |pmid=12009679 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0041134502026234 |issn=}}</ref> | Surgical revascularization may benefit patients with serum creatinine above 2.0 mg/dl.<ref name="pmid12009679">{{cite journal |author=Uzzo RG, Novick AC, Goormastic M, Mascha E, Pohl M |title=Medical versus surgical management of atherosclerotic renal artery stenosis |journal=Transplant. Proc. |volume=34 |issue=2 |pages=723–5 |year=2002 |month=March |pmid=12009679 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0041134502026234 |issn=}}</ref> | ||
Revision as of 05:37, 3 April 2009
Treatment
Various treatment options exist and no single therapy is superior to others according to a systematic review.[1]
A more recent trial suggests that surgery leads to better patency rates than angioplasty with stenting.[2]
Angioplasty with or without stents
Stenting improves the patency rates after angioplasty according to a randomized controlled trial.[3] This trial found no statistical significance in differences on blood pressure and renal function; however, this study excluded patients with reduced renal function due to their stensoses.
Surgery
Surgical revascularization may benefit patients with serum creatinine above 2.0 mg/dl.[4]
- ↑ Balk E, Raman G, Chung M, et al (December 2006). "Effectiveness of management strategies for renal artery stenosis: a systematic review". Ann. Intern. Med. 145 (12): 901–12. PMID 17062633. [e]
- ↑ Balzer KM, Pfeiffer T, Rossbach S, et al (March 2009). "Prospective randomized trial of operative vs interventional treatment for renal artery ostial occlusive disease (RAOOD)". J. Vasc. Surg. 49 (3): 667–74; discussion 674–5. DOI:10.1016/j.jvs.2008.10.006. PMID 19135837. Research Blogging.
- ↑ van de Ven PJ, Kaatee R, Beutler JJ, et al (January 1999). "Arterial stenting and balloon angioplasty in ostial atherosclerotic renovascular disease: a randomised trial". Lancet 353 (9149): 282–6. DOI:10.1016/S0140-6736(98)04432-8. PMID 9929021. Research Blogging.
- ↑ Uzzo RG, Novick AC, Goormastic M, Mascha E, Pohl M (March 2002). "Medical versus surgical management of atherosclerotic renal artery stenosis". Transplant. Proc. 34 (2): 723–5. PMID 12009679. [e]