What are my treatment options for Renal Artery Stenosis?
Treatment is dependent on your overall health and the symptoms experienced, but usually involves lifestyle changes, medication, or medical procedures. Oftentimes a combination of these therapies is the best option for management. Lifestyle modifications would include quitting smoking, trying to maintain a healthier weight, and getting regular exercise such as walking at least 30 minutes, 3 times a week. Also, it is very important to control other risk factors, by taking the appropriate prescribed medications to control blood pressure, cholesterol, and diabetes.
Medications prescribed by your vascular surgeon may include:
- ACE inhibitors or ARBs: helps relax your blood vessels and block the effects of a naturally occurring body chemical called angiotensin converting enzyme II, which narrows blood vessels
- Diuretics: help eliminate excess water from the body
- Beta blockers: make your heart beat slower and more effectively, and can widen and dilate the blood vessels
- Calcium channel blockers: relaxes blood vessels
- Statin drugs: these will help keep your cholesterol levels better controlled, preventing further plaque buildup in your arteries
In severe cases of renal artery stenosis, lifestyle modifications and medications may not be enough to help with symptoms. In this instance, the vascular surgeon will determine the best surgical or minimally invasive treatment that is best for you. This will depend on your overall health, presence of other conditions, and the location and extent of blockages.
- Angioplasty and Stenting: This is a minimally invasive procedure that involves inserting a long, thin flexible tube called a catheter through a small puncture over an artery in your arm or groin. Under x-ray guidance, this catheter is directed towards the blockage in the leg. A special balloon at the end of the catheter is deployed and deflated several times in order to compress the plaque against the walls of the artery. This widens the opening of the blood vessel, so blood is able to flow freely through it. In some instances, a mesh-like metal tube called a stent may be placed within the artery to keep it open. These procedures can be performed outpatient, with only a short 2 to 4-hour recovery period before the patient can go home.
- Bypass surgery: The surgeon will use either a synthetic cylinder-like tube called a graft or one of your own veins to reroute your blood flow around the renal artery blockage. The vein or graft is sewn above and below the area that is blocked, restoring blood flow to the tissues. This procedure requires a hospital stay of up to 5 days.
- Renal Artery Endarterectomy: The surgeon surgically removes the build-up of fats, cholesterol, and other substances (plaques) from the renal arteries.