UROLOGY · CONDITIONS
Renal Artery Stenosis
Narrowing of the renal artery causing renovascular hypertension and ischaemic nephropathy , correctable with angioplasty, stenting, or surgical bypass in selected patients.
ABOUT THIS CONDITION
What is Renal Artery Stenosis?
Renal artery stenosis reduces blood flow to the kidney, activating the renin-angiotensin system and causing renovascular hypertension that is resistant to multiple antihypertensive drugs. Bilateral RAS or RAS in a solitary kidney causes ischaemic nephropathy and flash pulmonary oedema. Atherosclerosis is the most common cause in older adults; fibromuscular dysplasia (FMD) affects younger women. Dr. Vipin coordinates the urological and vascular management of RAS , from Doppler screening and CT angiography through percutaneous transluminal angioplasty (PTRA) with stenting to surgical bypass for complex cases , working in collaboration with interventional radiology and vascular surgery.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Atherosclerosis , most common cause in adults over 50
- Fibromuscular dysplasia (FMD) , younger women, string-of-beads appearance
- Neurofibromatosis , renal artery involvement
- Vasculitis , Takayasu arteritis, polyarteritis nodosa
- Radiation-induced arterial injury to renal vessels
- Aortic aneurysm encroaching on renal artery origin
CLINICAL DETAILS
Key Facts
Renal Doppler ultrasound is non-invasive first-line screening , identifies asymmetric renal size and elevated peak systolic velocity.
CTA precisely defines stenosis degree, length, and morphology before planning intervention
Balloon angioplasty alone is first-line for FMD , excellent results without stenting usually needed.
Stenting after angioplasty for atherosclerotic ostial lesions to prevent elastic recoil
Statins, antiplatelet agents, and blood pressure control mandatory alongside intervention.
Renal artery bypass or endarterectomy reserved for failed angioplasty or complex anatomy.
HOW WE TREAT IT
Treatment Approach
Percutaneous Transluminal Renal Angioplasty (PTRA) Stenting
A balloon catheter widens the stenotic renal artery under fluoroscopy; a metal stent is deployed to maintain patency , the minimally invasive first-line treatment for haemodynamically significant renal artery stenosis.
- 1
Doppler & CTA
Renal Doppler identifies stenosis and renal size asymmetry. CT angiography confirms stenosis degree and morphology , guiding intervention planning.
- 2
Medical Optimisation
Statins, antiplatelet therapy, and optimal blood pressure control started before and continued after any revascularisation procedure.
- 3
PTRA Stenting
Percutaneous balloon angioplasty under fluoroscopy with stent deployment at the ostium for atherosclerotic RAS , performed under local anaesthesia as a day-to-one-day procedure.
- 4
Follow-up
Renal Doppler at 6 months checks stent patency and renal function. Blood pressure medications adjusted as hypertension improves post-stenting.
AVAILABLE TREATMENTS
Treatment Options
Percutaneous Transluminal Renal Angioplasty (PTRA) Stenting
Balloon angioplasty and stenting of the stenotic renal artery , first-line minimally invasive treatment for haemodynamically significant RAS.
Surgical Renal Artery Bypass
Saphenous vein or prosthetic graft bypass from the aorta to the renal artery beyond the stenosis , for failed angioplasty or complex anatomy.
Endarterectomy
Open surgical removal of atheromatous plaque from the renal artery orifice , effective for ostial atherosclerotic RAS, particularly during concurrent aortic surgery.
COMMON QUESTIONS
Frequently Asked
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