When is revascularization for atherosclerotic renal artery stenosis considered
In what situations may it be appropriate to consider revascularization for atherosclerotic renal artery stenosis?
Despite the results of trials that do not suggest patients with ischemic nephropathy or renovascular hypertension benefit from revascularization in general, there still may exist some situations in which revascularization is appropriate to attempt.
For example, it may be reasonable to try revascularization in patients with recurrent flash pulmonary edema.
Moreover, if a patient is intolerant of many antihypertensive medications or their hypertension cannot be adequately controlled with medications, revascularization would be reasonable to consider.
Finally, if a patient were rapidly losing kidney function, believed to be from atherosclerotic renal artery stenosis, it could be argued that because they will likely require dialysis or a transplant very soon if nothing else is done. In this situation the potential benefits of an attempted intervention may outweigh the risks.
