Conservative options
In its early stages or when not causing symptoms, renal artery stenosis may not require treatment. When treatment is needed, the goal is to slow disease progression and increase blood flow through the renal artery.
Conservative treatment options include:
- Condition management: If you have high blood pressure, high cholesterol or other chronic conditions, take your medicine properly and follow your healthcare provider’s instructions.
- Lifestyle modifications: Exercise regularly, eat a healthy diet, maintain a healthy weight and stop smoking.
- Medicines: Your healthcare provider may prescribe medicine to lower your blood pressure or slow the progression of kidney disease. Two medicines – angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers – do both. Your healthcare provider may also prescribe diuretics, beta blockers or calcium channel blockers.
Surgical intervention
When medicine and other conservative options don’t help, your healthcare provider may recommend surgery.
Angioplasty is a procedure to open arteries that are blocked or narrowed by plaque. It can be used in arteries throughout the body to restore blood flow.
Angioplasty is performed with either sedation to allow you to relax or while you’re asleep under general anesthesia. During the procedure, the doctor inserts a catheter into a blood vessel through a small incision in the arm or groin. The doctor then guides the catheter to the site of the blockage. A balloon at the tip of the catheter then inflates, compressing the plaque against the artery wall.
In many cases, doctors use a small metal mesh tube called a stent, which is placed through the catheter. Once inside the artery, the stent helps keep it open to improve blood flow. The stent may be coated in a medicine that helps prevent the artery from narrowing again.
After angioplasty, you’ll remain at the hospital for at least a few hours, possibly overnight. Your doctor may prescribe blood thinners to prevent additional clots. You can usually resume normal activities within a week. Your doctor will guide you on how often you will need follow-up visits to check that the angioplasty is working well and the stent, if you have one, is still in place.
Vascular bypass surgery creates a new path for blood to flow around a blocked or damaged artery. For this procedure, doctors use either a synthetic graft or a healthy vein from another part of your body. They locate the area of the blockage and then sew the graft above and below the blocked artery section. The blood is then rerouted through the graft.
After bypass surgery, you will stay in the hospital for a few days. After that, you may need to regain your strength and mobility with outpatient rehabilitation. Your doctor will let you know when to return to the office for a follow-up visit to have your stitches removed.
Renal endarterectomy is a surgery that allows doctors to remove plaque buildup from the renal artery.
Renal endarterectomy is performed while you are under general anesthesia. Your surgeon makes an incision in your abdomen or side and locates the plaque-filled area. A clamp temporarily stops the blood, which allows your doctor to carefully remove the plaque buildup from the inner lining of the artery. The artery is then sewn back together, and the clamp is removed.
After renal endarterectomy, you may spend a few nights in the hospital, followed by one to two weeks of recovery at home. You’ll visit your surgeon to have your stitches removed, and they’ll check to make sure there are no complications.
