Renal Artery Stenting NOT Beneficial

November 12th, 2009

Renal Artery Stenting NOT Beneficial

Richard A. Lange, MD, MBA

In patients with atherosclerotic renovascular disease, renal artery stenting carries no benefit when compared to medical therapy, but stenting does carry a substantial risk. In a recently published study, 806 patients were randomly assigned to undergo revascularization (almost exclusively done with stenting) in addition to medications or to medications alone (i.e, statin, antiplatelet agents, and optimal blood pressure medication). Interestingly – but not surprisingly – renal artery stenting did not improve blood pressure control or mortality, nor did it reduce renal or cardiovascular events over a 5 year followup period. In fact, it didn’t even help individuals with bilateral renal artery stenosis or those with the most severe stenosis.

Did you know that renal artery revascularization is performed in 16% of patients with newly diagnosed renal artery disease?

Based on this study, should we stop screening hypertensive patients for renal artery disease?

Are there any patients who benefit from renal artery stenting, and if so, who?

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November 12th, 2009