• Hemodynamically significant asymptomatic (incidental) RAS (is defined as:
1. 50% to 70% diameter stenosis by visual estimation with a peak translesional
gradient (measured with a ≤5F catheter or pressure wire) of 20 mm Hg or higher
or a mean gradient of 10 mm Hg orhigher; OR
2. any stenosis with 70% or larger diameter by visual estimation; OR
3. stenosis with 70% or larger diameter by intravascular ultrasound measurement
• HTA resistente: HTA CON TTO MAS DE TRES DROGAS A
DOSIS MAXIMA Q INCLUYE UN DIURETICO
• HTA ACELERADA: SUBITO Y RAPIDO DETERIORO.
• HTA CON DAÑO AGUDO DE UN ORGANO: IRA,
INS CARD AGUDA; NUEVo DISTURBIO NEUROLOGICO U
OFTALMOLOGICO .Y /O GRADO IIi/IV DE RETINOPATIA.
• noted that the National Kidney Foundation defines chronic kidney disease
as a decrease in estimated glomerular filtration rate to less than 60
mL/min per 1.73 m2 (modified Modification of Diet in Renal Disease
formula) that persists for at least 3 months
• Studios with a baseline serum creatinine between 1.5 and 4.0 mg per dL
• Several factors may argue against
– proteinuria greater than 1 g every 24 hours renal atrophy,
– severe renal parenchymal diseas disease, and severe diffuse
– intrarenal arteriolar disease.
• renal function can deteriorate after renal arteryangioplasty, especially in
patients with stable renal functionprior to the intervention
• Atherosclerotic renal artery stenosis: Current therapy
and future developments Am Heart J 2009;158:154-62
• Management of Renal Artery Stenosis Progress in
Cardiovascular Disease 52 (2009) 229–237
• Primary stenting for atherosclerotic renal artery
stenosis J Vasc Surg 2010;51:1574-80.)
• STAR Revascularization versus Medical Therapy for
Renal-Artery Stenosis N Engl J Med 2009;361:1953-62.
• RAS renal function: a randomized trial. Ann Intern Med
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