Renovascular Disease Management Strategies
Summary
Renovascular disease encompasses conditions arising from compromised renal perfusion, most commonly atherosclerotic renal artery stenosis and fibromuscular dysplasia. Management strategies hinge on accurate diagnosis, individualised risk stratification and targeted therapy to preserve renal function and control blood pressure. Initial assessment employs non-invasive imaging modalities—duplex ultrasonography, CT or MR angiography—reserving invasive angiography for equivocal cases or concurrent revascularisation. Medical treatment prioritises renin–angiotensin–aldosterone system blockade, rigorous blood pressure control, lipid lowering and modification of atherosclerotic risk factors. Endovascular revascularisation, chiefly percutaneous transluminal renal angioplasty with or without stenting, is indicated for patients with resistant hypertension, progressive renal impairment or recurrent flash pulmonary oedema. Emerging approaches integrate advanced imaging biomarkers and computational models to enhance patient selection and predict procedural outcomes, striving to balance procedural risks against potential renal and cardiovascular benefits through personalised treatment algorithms.
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Renovascular Disease Management Strategies publication trend
The graph below shows the total number of articles in renovascular disease management strategies across all publications each year (not limited to Nature Index journals).
Technical terms
Atherosclerotic renal artery stenosis (ARAS): Narrowing of the renal artery caused by atherosclerotic plaque accumulation.
Percutaneous transluminal renal angioplasty (PTRA): Endovascular procedure to dilate a stenosed renal artery, often with stent placement.
Radiomics: Computational extraction and analysis of quantitative imaging features to characterise tissue phenotypes.
Contrast-enhanced ultrasound (CEUS): Ultrasound imaging technique using microbubble contrast agents to visualise blood flow and vascular structures.
Parenchymal volume to single-kidney GFR ratio (PV:isoSK-GFR): Metric comparing renal tissue volume on MRI to single-kidney glomerular filtration rate for predicting functional recovery.
References
- CT-based radiomics: predicting early outcomes after percutaneous transluminal renal angioplasty in patients with severe atherosclerotic renal artery stenosis. Visual Computing for Industry, Biomedicine, and Art (2024).
- The Value of Contrast‐Enhanced Ultrasound versus Doppler Ultrasound in Grading Renal Artery Stenosis. BioMed Research International (2020).
- Kidney volume to GFR ratio predicts functional improvement after revascularization in atheromatous renal artery stenosis. PLOS ONE (2017).
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