Clinical perspective on renal artery stenosis: A single-center experience

OBJECTIVE: The aim of this paper is to evaluate the effectiveness of percutaneous angiographic stenting in carefully selected, symptomatic patients diagnosed with hemodynamically significant atherosclerotic renal artery stenosis (ARAS) followed in our clinic. MATERIALS AND METHODS: This retrospective study included 69 patients who underwent renal artery stenting due to renal artery stenosis between 2011 and 2023 in our clinic. Demographic, clinical, and laboratory data were retrospectively retrieved from the hospital's electronic health records. Duplex ultrasonography (DU) was used as the primary screening tool; however, the decision to stent was made only after confirmatory catheter angiography demonstrated ≥ 60% stenosis with an anatomically treatable lesion in a clinically high-risk context (resistant hypertension, acute kidney injury/acute-on-chronic kidney disease, or flash pulmonary edema). Laboratory parameters, blood pressure levels, and antihypertensive medication requirements were compared at baseline and 1 month following the procedure. RESULTS: = -1). The mean number of antihypertensive medications significantly decreased from baseline to 1 month after renal artery stenting (mean ± SD: 3.36 ± 1.37 vs. 2.10 ± 1.12; Wilcoxon signed-rank test, V = 1.693, p < 0.001, effect size r = 0.85 > 0.50). CONCLUSION: Intervention with stent placement in symptomatic/high-risk ARAS patients presenting with resistant hypertension, acute kidney injury, or flash pulmonary edema associated with significant renal artery stenosis can result in clinical improvement and a reduction in antihypertensive medication requirements, even within a short follow-up period of 4 weeks. Given the retrospective design, lack of a control group, and short follow-up, these findings should be interpreted as association rather than causation and cannot address long-term outcomes (e.g., restenosis, durable renal preservation, or cardiovascular events).