Fibromuscular dysplasia responds well to balloon dilatation, often resulting in a normal blood pressure.
Atherosclerosis may respond to balloon dilatation but the effect on blood pressure is unpredictable. If renal artery stenosis is bilateral, balloon dilatation often leads to improved renal function.
It is important for renal artery stenosis to be recognised before aortic reconstructive surgery, whether for aneurysmal or occlusive disease, as transient hypotension during surgery may initiate thrombotic occlusion at the site of renal artery stenosis and cause post-operative renal failure. Renal artery stenosis, therefore, if combined with the need for aortic arterial reconstruction, should be treated before, or in combination, with the aortic surgery.
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