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Efficacy of Revascularization For Renal Artery Stenosis Caused by Fibromuscular Dysplasia: A Systematic Review and Meta-Analysis
Open accessAbstract
In patients with fibromuscular dysplasia and renal artery stenosis, renal artery revascularization has been used to cure hypertension or to improve blood pressure control. To provide an up-to-date assessment of the benefits and risks associated with revascularization in this condition, we performed a systematic review of studies in which hypertensive patients with fibromuscular dysplasia renal artery stenosis underwent percutaneous transluminal renal angioplasty or surgical reconstruction. We assessed how often periprocedural complications and hypertension cure and improvement occurred. We selected 47 angioplasty studies (1616 patients) and 23 surgery studies (1014 patients). Combined rates of hypertension cure, defined according to the criteria in each study, after angioplasty or surgery were estimated to be 46% (95% CI: 40% to 52%) and 58% (95% CI: 53% to 62%), respectively, with substantial variations across studies. The probability of being cured was negatively associated with patient age and time of publication. Cure rates using current definitions of hypertension cure (blood pressure <140/90 mm Hg without treatment) were only 36% and 54% after angioplasty and surgery, respectively. The combined risks of periprocedural complications were 12% and 17% after angioplasty and surgery, respectively, with less major complications after angioplasty than surgery (6% versus 15%). In conclusion, angioplasty or surgical revascularization yielded moderate benefits in patients with fibromuscular dysplasia renal artery stenosis, with substantial variation across studies. The blood pressure outcome was strongly influenced by patient age.
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Cited by
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2017.11.006 · Cited by 6,616
Aboyans, V., Ricco, J.-B., Bartelink, M.-L. E. L., Björck, M., Brodmann, M., Cohnert, T., Collet, J.-P., Czerny, M., De Carlo, M., Debus, S., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehx095 · Cited by 3,293
2024 ESC Guidelines for the management of elevated blood pressure and hypertension
McEvoy, J. W., McCarthy, C. P., Bruno, R. M., Brouwers, S., Canavan, M. D., Ceconi, C., Christodorescu, R. M., Daskalopoulou, S. S., Ferro, C. J., Gerdts, E., et al. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae178 · Cited by 2,298
The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019)
Umemura, S., Arima, H., Arima, S., Asayama, K., Dohi, Y., Hirooka, Y., Horio, T., Hoshide, S., Ikeda, S., Ishimitsu, T., et al. (2019) · Hypertension Research · doi:10.1038/s41440-019-0284-9 · Cited by 1,880
Metadata
- Authors
- Trinquart, L., Mounier-Vehier, C., Sapoval, M., Gagnon, N., & Plouin, P.-F.
- Venue
- Hypertension
- Published
- 2010-09
- Volume
- 56
- Issue
- 3
- Pages
- 525-532
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2127657496
- Cited by
- 268
- References
- 0
- FWCI
- 11.07
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Trinquart, L., Mounier-Vehier, C., Sapoval, M., Gagnon, N., & Plouin, P.-F. (2010). Efficacy of Revascularization For Renal Artery Stenosis Caused by Fibromuscular Dysplasia: A Systematic Review and Meta-Analysis. Hypertension. https://doi.org/10.1161/hypertensionaha.110.152918
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