The Department of Cardiovascular Medicine, Beaumont Hospital-Royal Oak, Royal Oak, MI, USA.
Prog Cardiovasc Dis. 2021 Mar-Apr;65:60-70. doi: 10.1016/j.pcad.2021.03.003. Epub 2021 Mar 18.
Renal artery stenosis is the most common secondary cause of hypertension and predominantly caused by atherosclerosis. In suspected patients, a non-invasive diagnosis with ultrasound is preferred. Asymptomatic, incidentally found RAS does not require revascularization. In symptomatic patients requiring revascularization, renal artery stenting is the preferred therapy. Selecting appropriate patients for revascularization requires careful consideration of lesion severity and is optimized with a multidisciplinary team. All patients with atherosclerotic RAS should be treated with guideline-directed medical therapy, including hypertension control, diabetes control, statins, antiplatelet therapy, smoking cessation and encouraging activity.
肾动脉狭窄是高血压最常见的继发性病因，主要由动脉粥样硬化引起。在疑似患者中，首选超声进行非侵入性诊断。无症状、偶然发现的 RAS 不需要血运重建。对于需要血运重建的有症状患者，肾动脉支架置入术是首选治疗方法。选择适当的患者进行血运重建需要仔细考虑病变严重程度，并通过多学科团队进行优化。所有患有动脉粥样硬化性 RAS 的患者均应接受指南指导的药物治疗，包括控制高血压、控制糖尿病、他汀类药物、抗血小板治疗、戒烟和鼓励运动。
