11.12 Conclusion
Percutaneous renal revascularisation has become an accepted procedure for certain clinical indications. These include uncontrolled hypertension, especially when caused by FMD, flash pulmonary oedema and deteriorating renal function. There is evidence from one trial that it is more cost effective to treat ARAS by primary stenting. However, with easier access to non-invasive imaging, it is becoming clear that RAS is a common problem in our aging population. It is far from clear at present which of these patients should be treated to avoid renal artery occlusion and the consequent need for dialysis. The results of two randomised trials are awaited.
Stenosis of visceral arteries causing clinical symptoms is rare, but can be managed by percutaneous techniques. It is unlikely that there will ever be definitive data available concerning whether angioplasty or stenting are superior. However, based on data from the renal arteries the author generally chooses to stent ostial visceral artery stenoses and angioplasty truncal lesions.
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Cowling, M.G. (2007). Management of Renal and Visceral Arterial Stenoses. In: Cowling, M.G. (eds) Vascular Interventional Radiology. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33255-8_11
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