Executive Summary – Aug. 16, 2016
Renal Artery Stenosis Management Strategies: An Updated Comparative Effectiveness Review
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Background
Atherosclerotic renal artery stenosis (ARAS) is increasingly common in an aging population with rising prevalence of diabetes, hypertension, obesity, dyslipidemia, and vascular disease. The goals of treatment are improvement in uncontrolled hypertension, preservation or salvage of kidney function, prevention or treatment of cardiac syndromes such as pulmonary edema or unstable angina, and ultimately improved survival. Treatment alternatives include medical therapy alone or renal artery revascularization with continued medical therapy. Medical therapy generally involves aggressive therapy with multiple antihypertensives, antilipidemics, and antiplatelet agents. Most commonly, revascularization is achieved through percutaneous transluminal renal angioplasty with stent placement (PTRAS) across the stenosis. Open surgical revascularization, once common, is generally reserved for patients who have complicated renal artery anatomy or who require aortic repair. After revascularization, patients generally continue aggressive medical therapy. The Tufts Evidence-based Practice Center conducted a Comparative Effectiveness Review of management strategies for ARAS in 2006, with an update in 2007. The review concluded that the evidence did not support one treatment approach over another for the general population of people with ARAS. There was weak or inadequate evidence for most interventions and outcomes and for whether any clinical or intervention characteristics affect outcomes.
EHC Component
- EPC Project
Topic Title
- Renal Artery Stenosis Management Strategies: An Updated Comparative Effectiveness Review
Full Report
- Research Review Aug. 16, 2016
Related Products for this Topic
- Research Protocol Jan. 20, 2015
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