Stenting for renal artery stenosis to prevent cardiovascular complications

A data-only living systematic review

Clinical summary: This meta-analysis suggests that clinical intervention is not effective.

Methods overview: This repository is an openMetaAnalysis that updates a previously published meta-analysis.(1) Newer studies included are listed in the references below. Rationale for newer trials excluded may be listed at the end of the references.

This repository is a limited review and contains outcomes data only without PICO and Risk of Bias Tables. This review does not include a GRADE Profile or Summary of Findings Table.

See methods for details.

Results: Details of the studies included are in the:

• Forest plots (source data)

The forest plot for the primary outcome is below. Additional forest plots of secondary analyses may be available.

References:

Systematic review(s)

####Most recent review at time of last revision of this repository

1. Pierdomenico SD, Pierdomenico AM, Cuccurullo C, Mancini M, Di Carlo S, Cuccurullo F. Cardiac events in hypertensive patients with renal artery stenosis treated with renal angioplasty or drug therapy: meta-analysis of randomized trials. Am J Hypertens. 2012 Nov;25(11):1209-14. doi: 10.1038/ajh.2012.110. PMID: 22854636.

Randomized controlled trials

New trial(s) not included in the most recent review above

1. Cooper CJ, Murphy TP, Cutlip DE, Jamerson K, Henrich W, Reid DM, Cohen DJ, Matsumoto AH, Steffes M, Jaff MR, Prince MR, Lewis EF, Tuttle KR, Shapiro JI, Rundback JH, Massaro JM, D'Agostino RB Sr, Dworkin LD; CORAL Investigators. Stenting and medical therapy for atherosclerotic renal-artery stenosis. N Engl J Med. 2014 Jan 2;370(1):13-22. doi: 10.1056/NEJMoa1310753. PMID: 24245566.

Trials included in the review above

1. ASTRAL Investigators, Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, Carr S, Chalmers N, Eadington D, Hamilton G, Lipkin G, Nicholson A, Scoble J. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009 Nov 12;361(20):1953-62. doi: 10.1056/NEJMoa0905368. PMID: 19907042.
2. Bax L, Woittiez AJ, Kouwenberg HJ, Mali WP, Buskens E, Beek FJ, Braam B, Huysmans FT, Schultze Kool LJ, Rutten MJ, Doorenbos CJ, Aarts JC, Rabelink TJ, Plouin PF, Raynaud A, van Montfrans GA, Reekers JA, van den Meiracker AH, Pattynama PM, van de Ven PJ, Vroegindeweij D, Kroon AA, de Haan MW, Postma CT, Beutler JJ. Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial. Ann Intern Med. 2009 Jun 16;150(12):840-8, W150-1. PMID: 19414832.
3. Woittiez AJ, Bartelink AK, Man in 't Veld AJ, Schalekamp MA. The effect of balloon angioplasty on hypertension in atherosclerotic renal-artery stenosis. Dutch Renal Artery Stenosis Intervention Cooperative Study Group. N Engl J Med. 2000 Apr 6;342(14):1007-14. PMID: 10749962.
4. Webster J, Marshall F, Abdalla M, Dominiczak A, Edwards R, Isles CG, Loose H, Main J, Padfield P, Russell IT, Walker B, Watson M, Wilkinson R. Randomised comparison of percutaneous angioplasty vs continued medical therapy for hypertensive patients with atheromatous renal artery stenosis. Scottish and Newcastle Renal Artery Stenosis Collaborative Group. J Hum Hypertens. 1998 May;12(5):329-35. PMID: 9655655.
5. Scarpioni R, Michieletti E, Pavone L, Gandolfi S, Ricardi M, Pecchini P, Malberti F, Cristinelli L. Atherosclerotic renovascular disease (ARVD): medical therapy plus renal artery stenting (PRTS), compared with medical therapy alone, do not offer more chances in preventing C-V events or the progression of renal failure. Preliminary results of a prospective, multicenter and randomized trial. NDT Plus2009;2(Suppl 2): ii74.