Renal artery stenosis: diagnosis and treatment

Renal artery stenosis (RAS) leads to hypertension and renal dysfunction. The most common causes of RAS are fibromuscular dysplasia at younger ages, and atherosclerosis after 55 years of age. Coronary artery and lower extremity vascular diseases are frequently associated with atherosclerotic RAS. Flash pulmonary edema, deterioration in blood pressure control and renal function point to RAS. Duplex ultrasonography enables diagnosis without difficulty. Treatment consists of medical therapy and percutaneous or surgical revascularization. In the presence of refractory hypertension and/or renal dysfunction, mechanical revascularization is recommended. Percutaneous method is preferred to surgery due to high success and low complication rates. Revascularization therapy improves blood pressure control, renal function, and survival.