Escobar Guillermo A, Campbell Danielle N
Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Ann Vasc Surg. 2012 Apr;26(3):434-42. doi: 10.1016/j.avsg.2011.11.003. Epub 2012 Feb 2.
As the incidence of hypertension (HTN) continues to rise, finding the optimal treatment of this multifactorial disease is critical. Renal artery stenosis (RAS) is a known etiology for HTN and is associated with declining renal function. Other than medications, the original gold standard for treatment of HTN from RAS was with an open surgical revascularization or nephrectomy. Since then, endovascular interventions for RAS have been reported to be technically possible, but their efficacy over medications or surgery has yielded conflicting results in case series and randomized trials. This tabular review summarizes the results of randomized trials that compared the outcomes of endovascular renal artery interventions with nonendovascular techniques (including medical and surgical treatments) for the treatment of HTN and renal dysfunction. Based on these data, the strengths and weaknesses of individual trials are critically analyzed to better define the methods to identify and treat patients with RAS.
随着高血压（HTN）发病率持续上升，找到这种多因素疾病的最佳治疗方法至关重要。肾动脉狭窄（RAS）是已知的高血压病因，且与肾功能下降有关。除药物治疗外，RAS所致高血压的最初金标准治疗方法是开放性手术血运重建或肾切除术。从那时起，有报道称RAS的血管内介入治疗在技术上是可行的，但在病例系列研究和随机试验中，其相对于药物治疗或手术治疗的疗效产生了相互矛盾的结果。本表格综述总结了随机试验的结果，这些试验比较了血管内肾动脉介入治疗与非血管内技术（包括药物和手术治疗）治疗高血压和肾功能不全的疗效。基于这些数据，对各个试验的优缺点进行了批判性分析，以更好地确定识别和治疗RAS患者的方法。
