Comparison of Stenting Versus Best Medical Therapy for Treatment of Ostial Renal Artery Stenosis: a Trial in Patients With Advanced Atherosclerosis
Comparison of Stenting Versus Best Medical Therapy for Treatment of Ostial Renal Artery Stenosis: a Trial in Patients With Advanced Atherosclerosis
Renal artery stenosis (RAS) usually refers to a disease of the large extra-renal arterial
 vessels and most frequently is caused by atherosclerotic obstructions. The prevalence of
 atherosclerotic RAS increases with age, male gender, traditional cardiovascular risk factors
 (hypertension, diabetes, smoking, hyperlipidemia) and atherosclerotic comorbidities like
 coronary artery or peripheral artery disease (PAD). A prevalence up to 40% has been reported
 in patients with PAD. Undoubtedly, atherosclerotic RAS is a progressive disease, as more than
 half of the patients exhibit an increasing degree of stenosis within five years after
 diagnosis, and one out of five patients with a critical stenosis (>60%) suffers renal atrophy
 and renal failure during this period. RAS may be treated conservatively by so called best
 medical treatment, surgically, or by endovascular interventions using balloon angioplasty and
 stenting.

 The purpose of the investigators study is to determine the incidence and the predictors of
 RAS in patients with PAD, and to compare the effect of renal artery stenting versus best
 medical treatment in patients with hypertension and ostial renal artery stenosis in a
 randomized controlled trial.
Inclusion Criteria:

 -  PAD and unilateral ostial >60% RAS and hypertension

 Exclusion Criteria:

 -  Conditions which imply RAS stenting (bilateral significant renal disease, single
 functioning kidney, or patients whose conditions cannot be managed medically or by
 intervention)

 -  Allergy to contrast agents or medication administered for best medical treatment (in
 particular ASA and statins)