From the surgical management perspective, a typical treatment plan would center on an outpatient catheterization laboratory approach. For example, if the patient were persistently symptomatic (i.e., experiencing intractable hypertension), improvement to renal blood flow could be made via angioplasty or endovascular surgery. Angioplasty is less invasive; 50% of patients are cured, while 30% experience improvement. Angioplasty would also be suitable for non-calcified short arterial segments. Surgery is reported to result in less restenosis and greater improvement in glomerular filtration rate.
In Ms. M’s case, we cannot be sure whether or not her current renal artery hypertension was, indeed, the primary cause of her hypertension diagnosis 21 years ago. However, it was fortunate that the pathology was found and corrected with angioplasty before her hypertension progressed to more serious life-threatening conditions.
Dr. Korber is a clinical associate at the University of Illinois Medical Center at Chicago and a member of the Board of Directors for the Association of PAs in Cardiology.
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