Hemodynamic Measurements for the Selection of Patients With Renal Artery Stenosis: A Systematic Review

JACC. Cardiovascular Interventions
Peter M van BrusselBert-Jan van den Born

Abstract

Interventions targeting renal artery stenoses have been shown to lower blood pressure and preserve renal function. In recent studies, the efficacy of catheter-based percutaneous transluminal renal angioplasty with stent placement has been called into question. In the identification of functional coronary lesions, hyperemic measurements have earned a place in daily practice for clinical decision making, allowing discrimination between solitary coronary lesions and diffuse microvascular disease. Next to differences in clinical characteristics, the selection of renal arteries suitable for intervention is currently on the basis of anatomic grading of the stenosis by angiography rather than functional assessment under hyperemia. It is conceivable that, like the coronary circulation, functional measurements may better predict therapeutic efficacy of percutaneous transluminal renal angioplasty with stent placement. In this systematic review, the authors evaluate the available clinical evidence on the optimal hyperemic agents to induce intrarenal hyperemia, their association with anatomic grading, and their predictive value for treatment effects. In addition, the potential value of combined pressure and flow measurements to discriminat...Continue Reading

Citations

Apr 11, 2018·Current Hypertension Reports·Peter W de LeeuwAbraham A Kroon
May 1, 2019·Current Hypertension Reviews·Chrysoula BoutariAsterios Karagiannis
Jun 24, 2020·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Yoshio Iwashima, Toshihiko Ishimitsu
Jun 18, 2020·Journal of the American Society of Nephrology : JASN·Didier CollardBert-Jan H van den Born
Apr 11, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Peter M van BrusselBert-Jan H van den Born

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