Renal artery dissection — when endovascular repair fails to cure hypertension

Clinical scenario

This protocol applies to patients with renal artery dissection who have undergone endovascular repair but have not achieved the required blood pressure outcome. The question addressed is: what is the management step when the initial interventional approach does not reach the target?

Prior treatment — failure condition

The first-line approach was endovascular repair — stent placement in the renal artery. Escalation to this protocol is triggered when that intervention fails to achieve cured hypertension, defined as sustained blood pressure below 140/90 mmHg without the use of any antihypertensive drugs.

Next-line approach (partial overview)

When endovascular repair does not meet the blood pressure goal, a surgical intervention is indicated. The type of surgery applied depends on specific patient and anatomical factors — the full structured regimen details which option applies and under what conditions.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.jvs.2019.03.055

Surgical interventions, including extracorporeal renal artery bypass and complete nephrectomy, were reserved for patients refractory to conservative treatment.

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