Renal artery stenosis (RAS) is a common pathological condition associated with uncontrolled or re... more Renal artery stenosis (RAS) is a common pathological condition associated with uncontrolled or refractory hypertension, flash pulmonary edema, and worsening renal function. The high prevalence of RAS in patients with coronary and lower extremity vascular disease has been well established. In a recent study on the practice of "drive-by renal shooting", prevalence of significant RAS was found to be high in patients with suspected coronary atherosclerosis referred for coronary angiography. Another study revealed dramatic increase in volume of renal arterial stenting in the Medicare population. Hence, concerns of over-diagnosis and over-treatment of RAS were raised. However, numerous recent studies demonstrated high success rate of renal artery stent revascularization and its clinical benefits. Aggressive screening and early treatment of RAS are therefore warranted in patients with drug-refractory hypertension and/or worsening renal insufficiency. However, some open issues remain. The paper proposes selection criteria for "drive-by renal shooting" and suggests valid criteria for treating RAS.
Renal artery stenosis (RAS) is a common pathological condition associated with uncontrolled or re... more Renal artery stenosis (RAS) is a common pathological condition associated with uncontrolled or refractory hypertension, flash pulmonary edema, and worsening renal function. The high prevalence of RAS in patients with coronary and lower extremity vascular disease has been well established. In a recent study on the practice of "drive-by renal shooting", prevalence of significant RAS was found to be high in patients with suspected coronary atherosclerosis referred for coronary angiography. Another study revealed dramatic increase in volume of renal arterial stenting in the Medicare population. Hence, concerns of over-diagnosis and over-treatment of RAS were raised. However, numerous recent studies demonstrated high success rate of renal artery stent revascularization and its clinical benefits. Aggressive screening and early treatment of RAS are therefore warranted in patients with drug-refractory hypertension and/or worsening renal insufficiency. However, some open issues remain. The paper proposes selection criteria for "drive-by renal shooting" and suggests valid criteria for treating RAS.
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Papers by Rakesh sharma