Skip to main content
SpringerLink
Log in

Interventions for Renovascular Hypertension

  • Chapter
  • First Online:
Interventional Therapies for Secondary and Essential Hypertension

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

  • 847 Accesses

Abstract

Three major clinical symptoms result from significant renal artery stenosis (RAS): arterial hypertension, nephropathy, and destabilizing cardiac syndromes. Main etiologies of RAS are atherosclerosis (approximately 90 %) and fibromuscular dysplasia (FMD). Atherosclerotic RAS has a considerable overlap with atherosclerotic manifestation elsewhere and is associated with an overall poor prognosis. Technical improvements of diagnostic and interventional endovascular tools have led to a more widespread use of transluminal renal artery revascularization and extension of interventional indications during the past three decades. Plain balloon angioplasty is still considered the method of choice for the treatment of FMD, whereas stent implantation is indicated in ostial atherosclerotic RAS. However, despite positive retrospective single center experiences, none of the published randomized controlled trials could prove a benefit of RAS revascularization compared to medical management. These negative trials including the CORAL trial had significant flaws in study design; crucial for a clinical benefit of revascularization of RAS is a proper patient selection, revascularization is only indicated in hemodynamic relevant RAS. This chapter summarizes the epidemiology, indications for treatment, and technical aspects of endovascular treatment of RAS.

The authors do not have any conflict of interest with the content of this manuscript.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

BP:

Blood pressure

DUS:

Duplex ultrasound

e-GFR:

Estimated glomerular filtration rate

FMD:

Fibromuscular dysplasia

PTRA:

Percutaneous transluminal renal angioplasty

RAS:

Renal artery stenosis

RI:

Resistive index

References

  1. Harding MB, Smith LR, Himmelstein SI, Harrison K, Phillips HR, Schwab SJ, Hermiller JB, Davidson CJ, Bashore TM (1992) Prevalence and associated risk factors in patients undergoing routine cardiac catheterization. J Am Soc Nephrol 2:1608

    CAS  PubMed  Google Scholar 

  2. Missouris CG, Buckenham T, Cappuccio FP, MacGregor GA (1994) Renal artery stenosis: a common and important problem in patients with peripheral vascular disease. Am J Med 96:10–14

    Article  CAS  PubMed  Google Scholar 

  3. Zierler RE, Bergelin RO, Davidson RC, Cantwell-Gab K, Polissar NL, Strandness DE Jr (1996) A prospective study of disease progression in patients with atherosclerotic renal artery stenosis. Am J Hypertens 9:1055–1061

    Article  CAS  PubMed  Google Scholar 

  4. van Jaarsveld BC, Krijnen P, Pieterman H, Derkx FH, Deinum J, Postma CT, Dees A, Woittiez AJ, Bartelink AK, Man in ’t Veld AJ, Schalekamp MA, for the Dutch Renal Artery Stenosis Intervention Cooperative Study Group (2000) The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. N Engl J Med 342:1007–1014

    Article  PubMed  Google Scholar 

  5. Baumgartner I, Lerman LO (2011) Renovascular hypertension: screening and modern management. Eur Heart J 32(13):1590–1598

    Article  PubMed  PubMed Central  Google Scholar 

  6. Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clement D, Collet JF, Cremonesi A, De Carlo M, Erbel R, Fowkes FGR, Heras M, Kownator S, Minar E, Ostergren J, Poldermans D, Riambau V, Roffi M, Röther J, Sievert H, van Sambeek M, Zeller T (2011) ESC guidelines on the diagnosis and treatment of peripheral artery diseases: document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries. Eur Heart J 32:2851–2906

    Article  PubMed  Google Scholar 

  7. Rimmer JM, Gennari FJ (1993) Atherosclerotic renovascular disease and progressive renal failure. Ann Intern Med 118:712–719

    Article  CAS  PubMed  Google Scholar 

  8. Caps MT, Zierler RE, Polissar NL, Bergelin RO, Beach KW, Cantwell-Gab K, Casadei A, Davidson RC, Strandness DE Jr (1998) Risk of atrophy in kidneys with atherosclerotic renal artery stenosis. Kidney Int 53:735–742

    Article  CAS  PubMed  Google Scholar 

  9. Shanly PF (1996) The pathology of chronic renal ischemia. Semin Nephrol 16:21–32

    Google Scholar 

  10. Border WA, Noble NA (1998) Interactions of transforming growth factor-beta and angiotensin II in renal fibrosis. Hypertension 31:161–188

    Article  Google Scholar 

  11. Persu A, Touze E, Mousseaux E, Barral X, Joffre F, Plouin PF (2011) Diagnosis and management of fibromuscular dysplasia: an expert consensus. Eur J Clin Invest 42:338–347

    Article  PubMed  Google Scholar 

  12. Gottsäter A, Lindblad B (2014) Optimal management of renal artery fibromuscular dysplasia. Ther Clin Risk Man 10:583–595

    Article  Google Scholar 

  13. Trinquart L, Mounier-Vehier C, Sapoval M, Gagnon N, Plouin PF (2010) Efficacy of revascularization for renal artery stenosis caused by fibromuscular dysplasia: a systematic review and meta-analysis. Hypertension 56(3):525–532

    Article  CAS  PubMed  Google Scholar 

  14. Bax L, Woittiez AJ, Kouwenberg HJ, Mali WP, Buskens E, Beek FJ, Braam B, Huysmans FT, Schultze Kool LJ, Rutten MJ, Doorenbos CJ, Aarts JC, Rabelink TJ, Plouin PF, Raynaud A, van Montfrans GA, Reekers JA, van den Meiracker AH, Pattynama PM, van de Ven PJ, Vroegindeweij D, Kroon AA, de Haan MW, Postma CT, Beutler JJ (2009) Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function. Ann Intern Med 150:840–848

    Article  PubMed  Google Scholar 

  15. ASTRAL Investigators, Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, Carr S, Chalmers N, Eadington D, Hamilton G, Lipkin G, Nicholson A, Scoble J (2009) Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med 361:1953–1962

    Article  Google Scholar 

  16. Cooper CJ, Murphy TP, Cutlip DE, Jamerson K, Henrich W, Reid DM, Cohen DJ, Matsumoto AH, Steffes M, Jaff MR, Prince MR, Lewis EF, Tuttle KR, Shapiro JI, Rundback JH, Massaro JM, D’Agostino RB, Dworkin LD, for the CORAL Investigators (2014) Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med 370:13–22

    Article  CAS  PubMed  Google Scholar 

  17. Messerli FH, Bangalore S, Makani H, Rimoldi SF, Allemann Y, White CJ, Textor S, Sleight P (2011) Flash pulmonary oedema and bilateral renal artery stenosis: the Pickering Syndrome. Eur Heart J 32:2231–2237

    Article  PubMed  Google Scholar 

  18. Kane GC, Xu N, Mistrik E, Roubicek T, Stanson AW, Garovic VD (2010) Renal artery revascularization improves heart failure control in patients with atherosclerotic renal artery stenosis. Nephrol Dial Transplant 25(3):813–820

    Article  PubMed  Google Scholar 

  19. Zeller T, Rastan A, Schwarzwälder U, Müller C, Frank U, Bürgelin U, Sixt S, Schwarz S, Noory E, Neumann FJ (2007) Regression of left ventricular hypertrophy following stenting of renal artery stenosis. J Endovasc Ther 14:189–197

    Article  PubMed  Google Scholar 

  20. Zeller T, Frank U, Müller C, Bürgelin K, Bestehorn HP, Cook-Bruns N, Schwarzwälder U, Neumann FJ (2003) Predictors of improved renal function after primary stenting of severe atherosclerotic ostial renal artery stenosis. Circulation 108:2244–2249

    Article  PubMed  Google Scholar 

  21. Kalra PA, Chrysochou C, Green D, Cheung CM, Khavandi K, Sixt S, Rastan A, Zeller T (2010) The benefit of renal artery stenting in patients with atheromatous renovascular disease and advanced chronic kidney disease. Catheter Cardiovasc Interv 75:1–10

    Article  PubMed  Google Scholar 

  22. Gray BH, Olin JW, Childs MB, Sullivan TM, Bacharach JM (2002) Clinical benefit of renal artery angioplasty with stenting for the control of recurrent and refractory congestive heart failure. Vasc Med 7(4):275–279

    Article  PubMed  Google Scholar 

  23. Plouin PF, Chatellier G, Darne B, Raynaud A (1998) Blood Pressure outcome of angioplasty in atherosclerotic renal artery stenosis: a randomized trial. The EMMA-study group. Hypertension 31:823–829

    Article  CAS  PubMed  Google Scholar 

  24. Webster J, Marshall F, Abdalla M, Dominiczak A, Edwards R, Isles CG, Loose H, Main J, Padfield P, Russel IT, Walker B, Watson M, Wilkinson R (1998) 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 12:329–335

    Article  CAS  PubMed  Google Scholar 

  25. Nordmann AJ, Woo K, Parkes R, Logan AG (2003) Balloon angioplasty or medical therapy for hypertensive patients with atherosclerotic renal artery stenosis? A meta-analysis of randomized controlled trials. Am J Med 114:44–50

    Article  PubMed  Google Scholar 

  26. Rocha-Singh KJ, Mishkel GJ, Katholi RE et al (1999) Clinical predictors of improved long-term blood pressure control after successful stenting of hypertensive patients with obstructive renal artery atherosclerosis. Catheter Cardiovasc Interv 47:167–172

    Article  CAS  PubMed  Google Scholar 

  27. Watson PS, Hadjipetrou P, Cox SV, Piemonte TC, Eisenhauer AC (2000) Effect of renal artery stenting on renal function and size in patients with atherosclerotic renovascular disease. Circulation 102:1671–1677

    Article  CAS  PubMed  Google Scholar 

  28. Kawarada O, Yokoi Y, Morioka N, Shiotani S, Higashimori A (2010) Cardiac benefits of renal artery stenting. EuroIntervention 6(4):485–491

    Article  PubMed  Google Scholar 

  29. Dieter RS Darki A, Nanjundappa A, Chhokar VS, Khadim G, Morshedi-Meibodi A, Freihage JH, Steen L, Lewis B, Leya F (2009) Usefulness of wide pulse pressure as a predictor of poor outcome after renal artery angioplasty and stenting. Am J Cardiol 104(5):732–734

    Article  PubMed  Google Scholar 

  30. Radermacher J, Chavan A, Schäffer J, Stoess B, Vitzthum A, Kliem V, Bleck J, Gebel MJ, Galanski M, Brunkhorst R (2000) Detection of significant renal artery stenosis with color Doppler sonography: combining extrarenal and intrarenal approaches to minimize technical failure. Clin Nephrol 53(5):333–343

    CAS  PubMed  Google Scholar 

  31. Zeller T, Bonvini RF, Rastan A, Sixt S (2008) Colour-coded duplex ultrasound for diagnosis of renal artery stenosis and as follow-up examination after revascularization. Catheter Cardiovasc Interv 71:995–999

    Article  PubMed  Google Scholar 

  32. Krumme B, Blum U, Schwertfeger E, Flügel P, Höllstin F, Schollmeyer P, Rump L (1996) Diagnosis of renovascular disease by intrarenal and extrarenal Doppler scanning. Kidney Int 50:1288–1292

    Article  CAS  PubMed  Google Scholar 

  33. Radermacher J, Weinkove R, Haller H (2001) Techniques for predicting a favourable response to renal angioplasty in patients with renovascular disease. Curr Opin Nephrol Hypertens 10(6):799–805

    Article  CAS  PubMed  Google Scholar 

  34. Radermacher J, Chavan A, Bleck J, Vitzthum A, Stoess B, Gebel M et al (2001) Use of Doppler ultrasonography to predict the outcome of therapy for renal-artery stenosis. N Engl J Med 344:410–417

    Article  CAS  PubMed  Google Scholar 

  35. Zeller T, Müller C, Frank U, Bürgelin K, Horn B, Cook-Bruns N, Schwarzwälder U, Neumann FJ (2003) Stent-angioplasty of severe atherosclerotic ostial renal artery stenosis in patients with diabetes mellitus and nephrosclerosis. Catheter Cardiovasc Interv 58:510–515

    Article  PubMed  Google Scholar 

  36. Leesar MA, Varma J, Shapira A, Fahsah I, Raza ST, Elghoul Z, Leonard AC, Meganathan K, Ikram S (2009) Prediction of hypertension improvement after stenting of renal artery stenosis: comparative accuracy of translesional pressure gradients, intravascular ultrasound, and angiography. J Am Coll Cardiol 53:2363–2371

    Article  PubMed  Google Scholar 

  37. De Bryune B, Manoharan G, Pijls NHJ, Verhamme K, Madaric J, Bartunek J et al (2006) Assessment of renal artery stenosis severity by pressure gradient measurements. J Am Coll Cardiol 48:1851–1855

    Article  Google Scholar 

  38. Mahmud E, Smith TW, Palakodeti V, Zaidi O, Ang L, Mitchell CR, Zafar N, Bromberg-Marin G, Keramati S, Tsimikas S (2008) Renal frame count and renal blush grade: quantitative measures that predict the success of renal stenting in hypertensive patients with renal artery stenosis. JACC Cardiovasc Interv 1:286–292

    Article  PubMed  Google Scholar 

  39. Krishnamurthi V, Novick AC, Myles JL (1999) Atheroembolic renal disease: effect on morbidity and survival after revascularization for atherosclerotic renal artery stenosis. J Urol 161(4):1093–1096

    Article  CAS  PubMed  Google Scholar 

  40. Cooper C, Haller S, Colyer W, Steffes M, Burket MW, Thomas WJ, Safian R, Reddy BK, Brewster PS, Ankenbrandt M, Virmani R, Dippel EJ, Rocha-Singh K, Murphy TP, Kennedy DJ, Shapiro JI, D’Agostino R, Pencina MJ, Khuder SA (2008) Embolic protection and platelet inhibition during renal artery stenting. Circulation 117:2752–2760

    Article  CAS  PubMed  Google Scholar 

  41. Zeller T (2014) Renal artery stenosis. In: Zeller T, Cissarek T, Gray WA, Kröger K. Vascular medicine – therapy and practice, 2nd ed. Thieme. Stuttgart, New York, Delhi, Rio ISBN: 313176841X

    Google Scholar 

  42. Staub D, Zeller T, Trenk D, Maushart C, Uthoff H, Breidthardt T, Klima T, Aschwanden M, Socrates T, Arenja N, Twerenbold R, Rastan A, Sixt S, Jacob AL, Jaeger KA, Mueller C (2010) Use of B-type natriuretic peptide to predict blood pressure improvement after percutaneous revascularisation for renal artery stenosis. Eur J Vasc Endovasc Surg 40:599–607

    Article  CAS  PubMed  Google Scholar 

  43. Grüntzig A, Vetter W, Meier B, Kuhlmann U, Lütolf U, Siegenthaler W (1978) Treatment of renovascular hypertension with percutaneous transluminal dilatation of a renal artery stenosis. Lancet 1:801–802

    Article  PubMed  Google Scholar 

  44. Mahler F, Krneta A, Haertel M (1979) Treatment of renovascular hypertension by transluminal renal artery dilatation. Ann Intern Med 90:56–57

    Article  CAS  PubMed  Google Scholar 

  45. Baert AL, Wilms G, Amery A, Vermylen J, Suy R (1990) Percutaneous transluminal renal angioplasty: initial results and long-term follow-up in 202 patients. Cardiovasc Interv Radiol 13:22–28

    Article  CAS  Google Scholar 

  46. Bonelli FS, McKusick A, Textor SC, Kos PB, Stanson AW, Johnson CM, Sheedy PF 2nd, Welch TJ, Schirger A (1995) Renal artery angioplasty: technical results and clinical outcome in 320 patients. Mayo Clin Proc 70:1041–1052

    Article  CAS  PubMed  Google Scholar 

  47. Dorros G, Prince C, Mathiak L (1993) Stenting of renal artery stenosis achieves better relief of the obstructive lesion than balloon angioplasty. Catheter Cardiovasc Diagn 29:191–198

    Article  CAS  Google Scholar 

  48. Blum U, Krumme B, Flügel P, Gabelmann A, Lehnert T, Buitrago-Tellez C, Schollmeyer P, Langer M (1997) Treatment of ostial renal-artery stenoses with vascular endoprotheses after unsuccessful balloon angioplasty. N Engl J Med 336:459–465

    Article  CAS  PubMed  Google Scholar 

  49. Dorros G, Jaff M, Mathiak L, Dorros II, Lowe A, Murphy K, He T (1998) 4-year follow-up of Palmaz-Schatz stent revascularisation as treatment for atherosclerotic renal artery stenosis. Circulation 98:642–647

    Article  CAS  PubMed  Google Scholar 

  50. White CJ, Ramee SR, Collins TJ, Jenkins JS (1999) Renal artery stent placement: utility in lesions difficult to treat with balloon angioplasty. J Am Coll Cardiol 30:1445–1450

    Article  Google Scholar 

  51. van de Ven PJ, Kaatee R, Beutler JJ, Beek FJ, Woittiez AJ, Buskens E, Koomans HA, Mali WP (1999) Arterial stenting and balloon angioplasty in ostial atherosclerotic renovascular disease: a randomised trial. Lancet 353:282–286

    Article  PubMed  Google Scholar 

  52. Zeller T, Rastan A, Kliem M, Schwarzwälder U, Frank U, Bürgelin K, Schwarz T, Amantea P, Müller C, Neumann FJ (2005) Impact of carbon coating on restenosis rate after stenting of atherosclerotic renal artery stenosis. J Endovasc Ther 12:605–611

    Article  PubMed  Google Scholar 

  53. Sapoval M, Zähringer M, Pattynama P, Rabbia C, Vignali C, Maleux G, Boyer L, Szczerbo-Trojanowska M, Jaschke W, Hafsahl G, Downes M, Beregi JP, Veeger N, Talen A (2005) Low-profile stent system for treatment of atherosclerotic renal artery stenosis: The GREAT Trial. J Vasc Interv Radiol 16:1195–1202

    Article  PubMed  Google Scholar 

  54. Lederman RJ, Mendelsohn FO, Santos R, Phillips HR, Stack RS, Crowley JJ (2001) Primary renal artery stenting: characteristics and outcomes after 363 procedures. Am Heart J 142:314–323

    Article  CAS  PubMed  Google Scholar 

  55. Keddis MT, Garovic VD, Bailey KR, Wood CM, Raissian Y, Grande JP (2010) Ischaemic nephropathy secondary to atherosclerotic renal artery stenosis: clinical and histopathological correlates. Nephrol Dial Transplant 25:3615–3622

    Article  PubMed  PubMed Central  Google Scholar 

  56. Duranay M, Kanbay M, Akay H, Unverdi S, Sürer H, Altay M, Kırbaş I, Covic A, Zoccali C (2009) Nebivolol improves renal function in patients who underwent angioplasty due to renal artery stenosis: a pilot study. Nephron Clin Pract 114(3):c213–c217

    Article  PubMed  Google Scholar 

  57. Feldman RL, Wargovich TJ, Bittl JA (1999) No-touch technique for reducing aortic wall trauma during renal artery stenting. Catheter Cardiovasc Interv 46:245–248

    Article  CAS  PubMed  Google Scholar 

  58. Lin J, Li D, Yan F (2009) High-resolution 3D contrast-enhanced MRA with parallel imaging techniques before endovascular interventional treatment of arterial stenosis. Vasc Med 14(4):305–311

    Article  PubMed  Google Scholar 

  59. Rastan A, Krankenberg H, Müller-Hülsbeck S, Sixt S, Tübler T, Müller C, Schwarzwälder U, Frank U, Schwarz T, Leppaenen O, Neumann FJ, Zeller T (2008) Improved renal function and blood pressure control following renal artery angioplasty: the renal artery angioplasty in patients with renal insufficiency and hypertension using a dedicated renal stent device study (PRECISION). EuroIntervention 4(2):208–213, Erratum in: EuroIntervention. 2008 Nov; 4(3): table of contents

    Article  PubMed  Google Scholar 

  60. Cluzel P, Raynaud A, Beyssen B, Pagny JY, Gaux JC (1994) Stenoses of renal branch arteries in fibromuscular dysplasia: results of percutaneous transluminal angioplasty. Radiology 193:227–232

    Article  CAS  PubMed  Google Scholar 

  61. Zeller T, Rastan A, Schwarzwälder U, Müller C, Schwarz T, Frank U, Bürgelin K, Sixt S, Noory E, Beschorner U, Hauswald K, Branzan D, Neumann FJ (2007) Treatment of instent restenosis following stent-supported renal artery angioplasty. Catheter Cardiovasc Interv 70:454–459

    Article  PubMed  Google Scholar 

  62. Zeller T, Sixt S, Rastan A, Schwarzwälder U, Müller C, Noory E, Bürgelin K, Schwarz T, Hauswald K, Brantner R, Neumann FJ (2007) Treatment of reoccurring instent restenosis following reintervention after stent-supported renal artery angioplasty. Catheter Cardiovasc Interv 70:296–300

    Article  PubMed  Google Scholar 

  63. Henry M, Klonaris C, Henry I, Tzetanov K, Le Borgne E, Foliguet B, Hugel M (2001) Protected renal stenting with the PercuSurge GuardWire device: a pilot study. J Endovasc Ther 8:227–237

    Article  CAS  PubMed  Google Scholar 

  64. Del Conde I, Galin ID, Trost B, Kang J, Lookstein R, Woodward M, Gustavson S, Cambria RP, Jaff MR, Olin JW (2014) Renal artery duplex ultrasound criteria for the detection of significant in-stent restenosis. Catheter Cardiovasc Interv 83:612–618

    Article  PubMed  Google Scholar 

  65. Chi YW, White CJ, Thornton S, Milani RV (2009) Ultrasound velocity criteria for renal in-stent restenosis. J Vasc Surg 50(1):119–123

    Article  PubMed  Google Scholar 

  66. Fleming SH, Davis RP, Craven TE, Deonanan JK, Godshall CJ, Hansen KJ (2010) Accuracy of duplex sonography scans after renal artery stenting. J Vasc Surg 52(4):953–957; discussion 958

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Abteilung Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg – Bad Krozingen, Suedring 15, Bad Krozingen, 79189, Germany

    Thomas Zeller MD, Ulrich Beschorner MD & Elias Noory MD

Authors
  1. Thomas Zeller MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrich Beschorner MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elias Noory MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Thomas Zeller MD .

Editor information

Editors and Affiliations

  1. First Cardiology Clinic, National and Kapodistrian University of Athens, Athens, Greece

    Costas Tsioufis

  2. Department of Nephrology and Hypertension, University Hospital Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany

    Roland E. Schmieder

  3. IRCCS Istituto Auxologico Italiano, University Milano-Bicocca, Milano Monza, Italy

    Giuseppe Mancia

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Zeller, T., Beschorner, U., Noory, E. (2016). Interventions for Renovascular Hypertension. In: Tsioufis, C., Schmieder, R., Mancia, G. (eds) Interventional Therapies for Secondary and Essential Hypertension. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-34141-5_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-34141-5_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34140-8

  • Online ISBN: 978-3-319-34141-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation