Renal Artery Stenosis: Current Insights and Advances in Management

Abstract

Renal artery stenosis (RAS) presents a significant challenge in clinical practice, often leading to treatment-resistant hypertension and renal dysfunction. This review provides a comprehensive overview of the current insights and advances in managing RAS, encompassing its pathophysiology, diagnosis, treatment strategies, recent research, and future directions. RAS, predominantly caused by atherosclerosis or fibromuscular dysplasia, poses a substantial burden on affected individuals, necessitating early diagnosis and intervention to mitigate its adverse effects on renal function and cardiovascular health. Recent advancements in diagnostic imaging modalities, such as contrast-enhanced magnetic resonance angiography (CE-MRA) and phase-contrast magnetic resonance angiography (PC-MRA), offer enhanced anatomical and functional insights into RAS without requiring invasive procedures. Furthermore, innovative interventional techniques, including drug-eluting stents and minimally invasive surgical approaches, demonstrate promising outcomes in addressing complex RAS cases. Clinical trials, notably the CORAL trial, provide valuable evidence for the efficacy and safety of various management strategies, guiding clinicians in making informed decisions tailored to individual patient needs. Future directions in RAS research may involve further refinement of imaging techniques, exploration of personalized medicine approaches, and the development of targeted therapies to address underlying pathophysiological mechanisms. Collaborative efforts between clinicians, researchers, and industry partners are essential in driving innovation and advancing the field toward improved outcomes and quality of life for patients with RAS. Through continued research and innovation, the prognosis for patients with RAS promises enhanced management strategies and improved long-term outcomes.