Optimum medical treatment and stenting yielded similar results in a randomized trial.
Treating atherosclerotic renal artery stenosis and renal dysfunction by stenting is not supported by conclusive evidence, despite inclusion of this procedure in some practice guidelines (JW Cardiol Mar 23 2006). European investigators studied stent placement versus medical treatment alone in a randomized trial that involved 140 people with creatinine clearance <80 mL/minute and estimated atherosclerotic renal artery stenosis of ≥50% (usually determined by noninvasive imaging). About half the participants had bilateral stenosis. Of 64 patients assigned to the stent group, 46 actually received stents. (The most common reason for not receiving a stent was that stenosis was determined to be <50% at the time of the procedure.)
Subjects in both gr…