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Angiographic, Physiological, and Virtual Histology Indices of Renal Perfusion to Guide Renal Artery Stenting

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Endovascular Interventions

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Abstract

Renal artery stenosis (RAS) is predominantly due to atherosclerosis and is the most common cause of secondary hypertension. The disease is aorto-ostial, commonly involving the abdominal aorta and proximal one-third of the main renal artery. It has also been associated with hemodialysis-dependant renal failure and is a strong predictor of all-cause mortality. Clinical presentation generally involves malignant or resistant hypertension, renal insufficiency, or rarely, flash pulmonary edema. Once it develops, RAS is a progressive disease despite adequate medical therapy and can lead to asymptomatic occlusion.

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References

  1. Simon N, Franklin S, Bleifer K, et al. Clinical characteristics of renovascular hypertension. JAMA. 1972;220:1209–18.

    Article  PubMed  CAS  Google Scholar 

  2. van Ampting JM, Penne EL, Beek FJ, et al. Prevalence of atherosclerotic renal artery stenosis in patients starting dialysis. Nephrol Dial Transplant. 2003;18(6):1147–51.

    Article  PubMed  Google Scholar 

  3. Coen G, Calabria S, Lai S, et al. Atherosclerotic ischemic renal disease. Diagnosis and prevalence in a hypertensive and/or uremic elderly population. BMC Nephrol. 2003;4:2.

    Article  PubMed  Google Scholar 

  4. Mailloux LU, Napolitano B, Bellucci AG, et al. Renal vascular disease causing end-stage renal disease, incidence, clinical correlates, and outcomes: a 20-year clinical experience. Am J Kidney Dis. 1994;24:622–9.

    PubMed  CAS  Google Scholar 

  5. Safian RD, Textor SC. Renal-artery stenosis. N Engl J Med. 2001;344(6):431–42.

    Article  PubMed  CAS  Google Scholar 

  6. Schreiber MJ, Pohl MA, Novick AC. The natural history of atherosclerotic and fibrous renal artery disease. Urol Clin North Am. 1984;11(3):382–92.

    Google Scholar 

  7. Crowley JJ, Santos RM, Peter RH, et al. Progression of renal artery stenosis in patients undergoing cardiac catheterization. Am Heart J. 1993;136(5):913–8.

    Article  Google Scholar 

  8. Bax L, Woittiez AJ, Kouwenberg HJ, et al. Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial. Ann Intern Med. 2009;150:840–8.

    Article  PubMed  Google Scholar 

  9. Wheatley K, Ives N, Kalra P, et al. Revascularization versus medical therapy for renal-artery stenosis (ASTRAL). N Engl J Med. 2009;361:1953–62.

    Article  PubMed  Google Scholar 

  10. Mahmud E, Smith TW, Palakodeti V, et al. 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. 2008;1(3):286–92.

    Article  PubMed  Google Scholar 

  11. Subramanian R, White CJ, Rosenfield K, et al. Renal fractional flow reserve: a hemodynamic evaluation of moderate renal artery stenoses. Catheter Cardiovasc Interv. 2005;64:480–6.

    Article  PubMed  Google Scholar 

  12. De Bruyne B, Manoharan G, Pijls NH, et al. Assessment of renal artery stenosis severity by pressure gradient measurements. J Am Coll Cardiol. 2006;48:1851–5.

    Article  PubMed  Google Scholar 

  13. Mangiacapra F, Trana C, Sarno G, et al. Translesional pressure gradients to predict blood pressure response after renal artery stenting in patients with renovascular hypertension. Circ Cardiovasc Interv. 2010;3(6):537–42.

    Article  PubMed  Google Scholar 

  14. Leesar MA, Varma J, Shapira A, et al. Prediction of hypertension improvement after stenting of renal artery stenosis: comparative accuracy of translesional pressure gradients, intravascular ultrasound, and angiography. J Am Coll Cardiol. 2009;53(25):2363–71.

    Article  PubMed  Google Scholar 

  15. Mitchel JA, Subramanian R, White CJ, et al. Predicting blood pressure improvement in hypertensive patients after renal artery stent placement: renal fractional flow reserve. Catheter Cardiovasc Interv. 2007;69(5):685–9.

    Article  Google Scholar 

  16. Cooper CJ, Haller ST, Colyer W, et al. Embolic protection and platelet inhibition during renal artery stenting. Circulation. 2008;117(21):2752–60.

    Article  PubMed  CAS  Google Scholar 

  17. Prasad A, Ilapakurti M, Hu P, et al. Renal artery plaque composition is associated with changes in renal frame count following renal artery stenting. J Invasive Cardiol. 2011;23(6):227–31.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Interventional Cardiology, University of California, San Diego, 9434 Medical Center Drive, Mail Code #7784, La Jolla, CA, 92037-7784, USA

    Bahram Khadivi MD & Ehtisham Mahmud MD

  2. Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California, San Diego, 9434 Medical Center Drive, La Jolla, CA, 92037, USA

    Bahram Khadivi MD & Ehtisham Mahmud MD

Authors
  1. Bahram Khadivi MD
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  2. Ehtisham Mahmud MD
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Editor information

Editors and Affiliations

  1. Edward Hines, Jr. VA Hospital Loyola University Medical Center, Glen Ellyn, Illinois, USA

    Robert S. Dieter

  2. Northern Illinois Surgery Center, Naperville, Illinois, USA

    Raymond A. Dieter, Jr.

  3. University of Tennessee Medical Center, Knoxville, Tennessee, USA

    Raymond A. Dieter, III

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© 2014 Springer Science+Business Media New York

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Khadivi, B., Mahmud, E. (2014). Angiographic, Physiological, and Virtual Histology Indices of Renal Perfusion to Guide Renal Artery Stenting. In: Dieter, R., Dieter, Jr., R., Dieter, III, R. (eds) Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7312-1_34

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  • DOI: https://doi.org/10.1007/978-1-4614-7312-1_34

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7311-4

  • Online ISBN: 978-1-4614-7312-1

  • eBook Packages: MedicineMedicine (R0)

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