Jaff Michael R.
The Heart and Vascular Institute, 111 Madison Avenue, Fourth Floor, Morristown, NJ 07960, USA.
Curr Interv Cardiol Rep. 2001 May;3(2):93-99.
Atherosclerotic renal artery stenosis (RAS) is the most common secondary cause of hypertension, and often results in hypertension that is difficult to control. Atherosclerotic RAS may also result in chronic renal insufficiency, and although controversial, likely leads to end-stage renal failure in a subset of patients. Bilateral RAS, or stenosis to a solitary functioning kidney, has resulted in recurrent episodes of "flash" pulmonary edema and unstable angina pectoris. Despite these serious sequelae of RAS, there remains no consensus on optimal therapy. Invasive therapy (endovascular percutaneous transluminal angioplasty, with or without stent deployment; surgical revascularization) has generated significant interest among interventional physician specialists. However, effective antihypertensive therapy may be a reasonable option in certain scenarios.
动脉粥样硬化性肾动脉狭窄（RAS）是高血压最常见的继发性病因，常导致难以控制的高血压。动脉粥样硬化性RAS还可能导致慢性肾功能不全，尽管存在争议，但可能在一部分患者中导致终末期肾衰竭。双侧RAS或孤立功能肾的狭窄已导致反复发作的“闪击性”肺水肿和不稳定型心绞痛。尽管RAS有这些严重后果，但对于最佳治疗仍未达成共识。侵入性治疗（血管内经皮腔内血管成形术，有无支架置入；外科血管重建术）已引起介入内科专家的极大兴趣。然而，在某些情况下，有效的抗高血压治疗可能是一个合理的选择。
