When is surgery indicated as first-line treatment for renal artery stenosis (RAS)?

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

In some institutions, PTAS is the first-step approach in patients with IRD, and practitioners reserve surgery for the technical failure of percutaneous maneuvers. However, surgery remains the first choice of treatment under certain conditions, including the following:

  • Simultaneous abdominal aortic aneurysm
  • Renal artery aneurysm
  • Renal artery occlusion (with unsuccessful thrombolysis)
  • Renal artery rupture
  • Renal artery stenosis secondary to kinking
  • Peripheral multifocal stenosis
  • Unsuccessful angioplasty

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