Ricco Jean-Baptiste, Belmonte Romain, Illuminati Guilio, Barral Xavier, Schneider Fabrice, Chavent Bertrand
Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France -
Department of Vascular Surgery, University Hospital of Poitiers, Poitiers, France.
J Cardiovasc Surg (Torino). 2017 Apr;58(2):329-338. doi: 10.23736/S0021-9509.16.09827-X. Epub 2016 Dec 19.
The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS.
高血压患者动脉粥样硬化性肾动脉狭窄（ARAS）的管理一直是极具争议的话题。当代主要临床试验，如肾动脉病变的心血管结局（CORAL）试验和肾动脉粥样硬化病变血管成形术和支架置入术（ASTRAL）试验，均未能显示出血管重建术在控制血压和保护肾功能方面比药物治疗有显著益处。我们在此阐述这些试验的意义和局限性，并制定ARAS管理的建议。
