Decision support only. Not medical advice. Consult a licensed clinician before initiating or changing therapy.

Patient 024

64y·male·white·ASCVD 22.4% · SBP 158 mmHg · Chol 210 mg/dL

1 active reversal flag

  1. NephrologyModerate

    Renal artery stenting for atherosclerotic renal artery stenosis

    Why flagged

    Renal artery stent referral for ARAS patient; CORAL 2014 showed no benefit over medical therapy alone (35.1% vs. 35.8% events, p=NS).

    1. Prior guidance2014

      Routine angioplasty and stenting for significant atherosclerotic renal artery stenosis to treat refractory hypertension and preserve kidney function.

    2. CORAL2014

      Renal artery stenting added to medical therapy yielded no significant difference in CV/renal events (35.1% vs. 35.8%, HR 0.94; 95% CI 0.76-1.17) compared to medical therapy alone.

    3. Reversal2014

      Guidelines updated

    4. Current recommendation

      ACC/AHA Guidelines: Comprehensive medical therapy is the foundational treatment. Stenting provides no incremental benefit over medical therapy for most patients.