Abdominal: Renal Artery Stenosis- Page 1

Hypertension affects more than 60 million Americans and is a leading cause of morbidity and mortality. While renal artery stenosis is an uncommon cause of hypertension, it is important because it is treatable and potentially curable. Renovascular hypertension tends to be more difficult to control with pharmacological treatment, and is therefore more prone to incomplete treatment and resulting complications. The gold standard for imaging renal artery stenosis is catheter angiography. However, angiography is an invasive and expensive procedure which involves the risks of arterial catheterization. The search for tests for renal artery stenosis has led to the evaluation of a number of imaging techniques including captopril radionuclide renography, duplex ultrasound, and MR angiography, each of which has been shown to have significant limitations in terms of sensitivity, specificity, and reproducibility. CT angiography has shown tremendous promise as a noninvasive method for reliably detecting renal artery stenosis. Initial studies of CT angiography have reported sensitivities of 92-100% and specificities of 83-100% for significant renal artery stenosis. At our institution, CT angiography has become an important noninvasive screening test for patients with suspected renovascular hypertension.