Aterosclerotic stenosis of renal artery (ASRA) represents a common condition related to hypertension, progressive renal failure and cardiovascular morbidity [1,2]. The clinical efficacy of endovascular therapy of renal artery stenosis is still controversial [3]. According to the results of two important randomized and controlled trials (ASTRAL and STAR) there were not a significant advantage of endovascular procedures compared to medical therapy alone, in improving renal function and blood pressure values [4,5,6]. These two studies should be anyway considered not conclusive, because of their intrinsic bias....

135 patients (86 men, 49 women, mean age : 64) treated with RASP between January 2007 and December 2011, were retrospectively evaluated. Diagnosis of ASRA was suggested by colour Doppler ultrasound (ECD)findings (Fig. 1Fig. 2)and confirmed by CT or MRI (Fig. 3). All patients had indications for RASP according to our inclusion criterions: renal artery stenosis > 70% resistant hypertension to a 3 drug regimen altered renal function stenosis < 70% in solitary functioning kidney patients with reduction of renal bipolar diameter The exclusion criterions...

Immediate technical success was obtained in all patients. Three minor complications (1 mononeuropahty of the median nerve for local trauma, 1 arteriovenous fistula and 1 pseudoaneurysm of the femoral artery) were reported (Fig. 7) Significant hemodynamic restenosis after 1 year occurred in 9/94 patients (plus 3 cases of not hemodynamic significant restenosis) (Fig. 8). All these 9 cases were treated again trough angioplasty (only in 2/9 cases a new stent was placed). Considering the 74 patients who were followed for two years (group 1), we...

The differences between the pre- and postprocedural sistolic blood pressure, diastolic blood pressure and serum creatinin average values were statistically significant (p< 0.05). Immediate technical success was obtained in all patients. Only minor complications occurred and the incidence of significant hemodynamic restenosis at 12 months was 9.6 %. According to our experience RASP represents a safe procedure characterized by a low risk of complications. In patients with defined indications this endovascular procedure is effective in improving renal function and blood pressure control.

[1] Hansen KJ, Edwards MS, Craven TE, Cherr GS, Jackson Sa,Appel RG, Burke Gl, Dean RH. Prevalence Of Renovascular Disease In The Elderly: A Population Based Study. J Vasc Surg 36:443–451, 2002. [2] SafianRD,Textor SC. Renal-artery stenosis. N Engl J Med. 2001 Feb 8;344(6):431-42. [3] HirschAT,HaskalZJ,Herzter NR et al. ACC/AHA 2005 PracticeGuidelinesfor themanagementofpatientswithperipheral arterial disease(lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association forVascularSurgery/Society forVascularSurgery, Society for Cardiovascular Angiography and Interventions, Society forVascularMedicine and Biology, Society of Interventional Radiology, and...