Management of the Occluded Renal Artery

Abstract

In the patient with compromised renal function or poorly controlled hypertension, nonoperative treatment of the chronically occluded renal artery is frequently associated with progression to renal failure and worsening blood pressure control. As a consequence, a policy of revascularization in the hopes of optimizing the patient's long-term outcome has been advocated. This approach has been tempered by the frequency of associated extrarenal vascular disease, which enhances the potential risk of any major vascular reconstruction and the absence in many patients of unambiguous laboratory or clinical characteristics, which can identify those kidneys likely to benefit from an attempt at revascularization. This review highlights the issues and available options for the management of the occluded renal artery