TY - JOUR
T1 - New diagnostic and treatment strategies in renal artery stenosis
T2 - A promising pursuit or disappointment foretold?
AU - van de Velde, L.
AU - Collard, D.
AU - Spiering, W.
AU - van Brussel, P.M.
AU - Versmissen, J.
AU - Wierema, T.
AU - de Haan, M.W.
AU - Zijlstra, IJ.A.J.
AU - Kroon, A.A.
AU - Vogt, L.
AU - de Leeuw, P.W.
AU - van Twist, D.
AU - van den Born, B.J.H.
PY - 2020/9
Y1 - 2020/9
N2 - Clinical management of renal artery stenosis has seen a major shift, after randomised clinical trials have shown no group benefit of endovascular intervention relative to optimal medical control. However, the inclusion criteria of these trials have been criticised for focusing on a subset of patients with atherosclerotic renal artery stenosis where intervention was unlikely to be beneficial. Moreover, new imaging and computational techniques have become available, which have the potential to improve identification of patients that will respond to interventional treatment. This review addresses the challenges associated with clinical decision making in patients with renal artery stenosis. Opportunities for novel diagnostic techniques to improve patient selection are discussed, along with ongoing Dutch studies and network initiatives that investigate these strategies.
AB - Clinical management of renal artery stenosis has seen a major shift, after randomised clinical trials have shown no group benefit of endovascular intervention relative to optimal medical control. However, the inclusion criteria of these trials have been criticised for focusing on a subset of patients with atherosclerotic renal artery stenosis where intervention was unlikely to be beneficial. Moreover, new imaging and computational techniques have become available, which have the potential to improve identification of patients that will respond to interventional treatment. This review addresses the challenges associated with clinical decision making in patients with renal artery stenosis. Opportunities for novel diagnostic techniques to improve patient selection are discussed, along with ongoing Dutch studies and network initiatives that investigate these strategies.
KW - Computational fluid dynamics
KW - Fibromuscular dysplasia
KW - Functional measurements
KW - Renal artery stenosis
KW - Renovascular disease
KW - Secondary hypertension
UR - http://www.scopus.com/inward/record.url?scp=85091738581&partnerID=8YFLogxK
M3 - Review article
AN - SCOPUS:85091738581
SN - 0300-2977
VL - 78
SP - 232
EP - 238
JO - Netherlands journal of medicine
JF - Netherlands journal of medicine
IS - 5
ER -
