This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Zierler, R. E. Search for Related Content PubMed Articles by Zierler, R. E. Social Bookmarking                         What's this?

Atherosclerotic Renovascular Disease: Natural History and Diagnosis

Department of Surgery, Division of Vascular Surgery, University of Washington School of Medicine; gzierler{at}u.washington.edu

Atherosclerosis is the most common cause of renovascular disease and can result in hypertension and ischemic nephropathy. Natural history studies have shown that atherosclerotic renal artery stenosis tends to progress over time. Risk factors associated with disease progression include systolic hypertension, diabetes mellitus, and severe renal artery stenosis. Kidneys with stenotic renal arteries are also at risk for atrophy and deterioration in renal function. Early renal revascularization may improve this natural history; however, randomized clinical trials will be necessary to define the role of renal revascularization in this setting. Duplex ultrasound is a reliable screening test for renal artery stenosis that provides distinct advantages in terms of cost and risk compared with other imaging techniques. Ultrasound may also be valuable in predicting the functional response to renal artery interventions. Computed tomography (CT) and magnetic resonance angiography (MRA) are accurate anatomic tests for renal artery disease, but spiral CT requires relatively high volumes of iodinated contrast. MRA permits visualization of the main renal arteries and accessory renal arteries without ionizing radiation or iodinated contrast. Screening by either duplex ultrasound or MRA should limit the use of contrast arteriography to those patients who are candidates for direct renal artery interventions.

Key Words: renal artery stenosis • duplex ultrasound • spiral computed tomography • magnetic resonance angiography

Perspectives in Vascular Surgery and Endovascular Therapy, Vol. 16, No. 4, 299-310 (2004)
DOI: 10.1177/153100350401600412


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?