Endovascular Procedures for Renovascular Disease

Abstract

While open surgical revascularization remains the gold standard, other endovascular techniques for renal revascularization, including percutaneous transluminal angioplasty with or without endoluminal stent placement (PTAS), have emerged as another option. Preoperative evaluation and procedural planning (including patient preparation, correlation of diagnostic images with clinical findings, and materials and instruments) are discussed. The procedural technique is described and includes the steps of securing the renal artery access for therapeutic intervention, transluminal angioplasty, and endoluminal stenting. Postprocedural care, complications, and outcome evaluation are also presented. Nearly one dozen figures show various diagnostic images, including CT scans, aortograms, and arteriography. Tables show the standard equipment for renal PTAS, a summary of trials included in meta-analysis, and results after primary arterial stent placement for atherosclerotic renal artery stenosis. This review contains 71 references.