Renal artery stenosis is a condition where the arteries leading to the kidneys become narrowed secondary to atherosclerosis. This condition should be suspected in patients who have severe hypertension which does not respond to medications, especially if there is also worsening kidney failure.
Renal artery stenosis, if suspected, is usually evaluated with an ultrasound as the initial test. A renal artery duplex ultrasound can often see flow velocities which are elevated, indicating a narrowing in the artery. If the ultrasound is suspicious, further evaluation can be performed with a CT scan, an MRA, or an angiogram.
Renal artery stenosis is most commonly treated with angioplasty and stenting. Again, this procedure is performed via a small puncture in the artery in the groin (femoral artery). Advanced x rays are used to position the stent in the exact location of the narrowed renal artery. The stent is deployed, holding the artery open, and allowing the free flow of blood into the kidney.