Is time of renal hypoperfusion an important variable in determining response to renal artery revascularization?

摘要

The CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) trial found that stent implantation did not provide any benefit beyond optimal medical therapy in the occurrence of death or adverse cardiovascular or renal events in patients with moderately severe atherosclerotic renal artery stenosis (1). There was a modest, consistent difference in systolic blood pressure favoring the stent group, but this did not result in a decrease in adverse clinical outcomes. These findings are consistent with the ASTRAL (Angio-plasty and Stenting for Renal Atherosclerotic Lesions) trial (2) and the STAR (Stent Placement and Blood Pressure and Lipid-Lowering for the Prevention of Progression of Renal Dysfunction Caused by Atherosclerotic Ostial Stenosis ofthe Renal Artery) trial (3).