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A clinical approach to the management of a patient with suspected renovascular disease who presents with leg ischemia

Plouin, PF; Clement, DL; Boccalon, H; Dormandy, J; Durand-Zaleski, I; Fowkes, G; Norgren, Lars LU and Brown, T (2003) In International Angiology 22(4). p.333-339
Abstract
Athernsclerotic renal artery stenosis (ARAS) may cause hypertension, progressive renal failure, and recurrent pulmonary edema. It typically occurs in high risk patients with coexistent vascular disease elsewhere. Most patients with ARAS are likely to die from coronary heart disease or stroke before end-stage renal failure occurs. Recent controlled trials have shown that most patients undergoing angioplasty to treat renovascular hypertension still need antihypertensive agents 6 or 12 months after the procedure. Nevertheless, the number of antihypertensive agents required to control blood pressure adequately is lower following angioplasty than for medication alone. Trials assessing the value of revascularization for preserving renal function... (More)
Athernsclerotic renal artery stenosis (ARAS) may cause hypertension, progressive renal failure, and recurrent pulmonary edema. It typically occurs in high risk patients with coexistent vascular disease elsewhere. Most patients with ARAS are likely to die from coronary heart disease or stroke before end-stage renal failure occurs. Recent controlled trials have shown that most patients undergoing angioplasty to treat renovascular hypertension still need antihypertensive agents 6 or 12 months after the procedure. Nevertheless, the number of antihypertensive agents required to control blood pressure adequately is lower following angioplasty than for medication alone. Trials assessing the value of revascularization for preserving renal function or preventing clinical events are only in the early recruitment phase. Revascularization should be undertaken in patients with ARAS and resistant hypertension or heart failure, and probably in those with rapidly deteriorating renal function or with an increase in plasma creatinine levels during angiotensin-converting enzyme inhibition. With or without revascularization, medical therapy using antihypertensive, hypolipidemic and antiplatelet agents is necessary in almost all cases. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
peripheral vascular diseases, therapy, angioplasty, balloon, anti-hypertensive agents, risk factors, hypertension, renovascular
in
International Angiology
volume
22
issue
4
pages
333 - 339
publisher
Minerva Medica
external identifiers
  • wos:000220430000001
  • pmid:15153815
  • scopus:1542621092
ISSN
1827-1839
language
English
LU publication?
yes
id
69442d34-8c21-4a27-8036-b4e955432f99 (old id 283626)
date added to LUP
2007-08-03 15:44:10
date last changed
2018-01-07 05:30:52
@article{69442d34-8c21-4a27-8036-b4e955432f99,
  abstract     = {Athernsclerotic renal artery stenosis (ARAS) may cause hypertension, progressive renal failure, and recurrent pulmonary edema. It typically occurs in high risk patients with coexistent vascular disease elsewhere. Most patients with ARAS are likely to die from coronary heart disease or stroke before end-stage renal failure occurs. Recent controlled trials have shown that most patients undergoing angioplasty to treat renovascular hypertension still need antihypertensive agents 6 or 12 months after the procedure. Nevertheless, the number of antihypertensive agents required to control blood pressure adequately is lower following angioplasty than for medication alone. Trials assessing the value of revascularization for preserving renal function or preventing clinical events are only in the early recruitment phase. Revascularization should be undertaken in patients with ARAS and resistant hypertension or heart failure, and probably in those with rapidly deteriorating renal function or with an increase in plasma creatinine levels during angiotensin-converting enzyme inhibition. With or without revascularization, medical therapy using antihypertensive, hypolipidemic and antiplatelet agents is necessary in almost all cases.},
  author       = {Plouin, PF and Clement, DL and Boccalon, H and Dormandy, J and Durand-Zaleski, I and Fowkes, G and Norgren, Lars and Brown, T},
  issn         = {1827-1839},
  keyword      = {peripheral vascular diseases,therapy,angioplasty,balloon,anti-hypertensive agents,risk factors,hypertension,renovascular},
  language     = {eng},
  number       = {4},
  pages        = {333--339},
  publisher    = {Minerva Medica},
  series       = {International Angiology},
  title        = {A clinical approach to the management of a patient with suspected renovascular disease who presents with leg ischemia},
  volume       = {22},
  year         = {2003},
}