Journal «Angiology and Vascular Surgery» • 

2007 • VOLUME 13 • №1

ENDOVASCULAR TREATMENT OF A RENAL ARTERY STENOSIS: TECHNIQUES, INDICATIONS, RESULTS. ROLE OF EMBOLIC PROTECTION DEVICES (PART 1)

M. Henry, I. Henry, A. Polydorou, Ad. Polydorou, M. Hugel
Cabinet de Cardiologie, Nancy France
Global Research Institute, Appolo Hospital Complex, Hyderabad India
Polyclinique Bois Bernard, Bois Bernard France
Panteleimon General Hospital, Athens Greece

A renal artery stenosis (RAS) is frequent and increasingly recognized thanks to technical improvements in duplex ultrasound, magnetic resonance angiography, CT scan, systemic angiography during catheterization.

RAS is most of the time atheromatous (80% of the cases and over 40 years) but can also be due to fibromuscular dysplasia which may be diagnosed in <10% of the cases, more often in young patients, more commonly women, producing hyperplasia and fibrosis of the intima, the media or the adventicia. Dysplasia of the media accounts for over two thirds of cases and produces the typical "string of beads" appearance of the renal artery. Other causes of RAS can be recognised: arteritis (Takayasu's disease), neurofibromatosis, radiations. It can also be diagnosed in a renal transplant and renal bypass grafts.

The prevalence of RAS is high. RIHAL found a RAS greater than 50% in 19.2% of patients during cardiac catheterization of 297 hypertensive patients. The prevalence of RAS is 35 to 45% in patients with peripheral vascular disease, 14 to 24% in patients with cerebrovascular disease, 7 to 30% in patients with coronary heart disease. In patients with renal insufficiency, the incidence of unsuspected RAS is as high as 24%. RAS greater than 60% has been reported to be 6.8% in patients older than 65 years of age.

KEY WORDS: renal artery stenosis, percutaneous transluminal renal angioplasty, renal insufficiency, vasorenal hype-rtension.

P. 33-40

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