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Renal artery stenosis (RAS) is the narrowing of one or both of the renal arteries, most often caused by atherosclerosis or fibromuscular dysplasia. This narrowing of the renal artery can impede blood flow to the target kidney , resulting in renovascular hypertension – a secondary type of high blood pressure .
An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the inner layer of an arterial wall. [1] [2]The material consists of mostly macrophage cells, [3] [4] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue.
Generally an atheroma becomes vulnerable if it grows more rapidly and has a thin cover separating it from the bloodstream inside the arterial lumen. Tearing of the cover is called plaque rupture . However, a repeated atheroma rupture and healing is one of the mechanisms, perhaps the dominant one, that creates artery stenosis .
Atherosclerosis [a] is a pattern of the disease arteriosclerosis, [8] characterized by development of abnormalities called lesions in walls of arteries.This is a chronic inflammatory disease involving many different cell types and is driven by elevated levels of cholesterol in the blood. [9]
This leads to a build-up of plaques and they can be deposited in the renal arteries causing stenosis and ischemic kidney disease. [citation needed] In this situation, the kidney supplied blood by the narrowed renal artery suffers from inadequate blood flow, which in turn causes the size of the kidneys to decrease. Other consequences include ...
In treating renal artery disease, a 2014 study indicates that balloon angioplasty can improve diastolic blood pressure and potentially reduce antihypertensive drug requirements. [30] In the case of peripheral artery disease, treatment to prevent complications is important; without treatment, sores or gangrene (tissue death) may occur.
Angiotension converting enzyme. The pathogenesis of renovascular hypertension involves the narrowing of the arteries supplying the kidneys which causes a low perfusion pressure that is detected by the juxtaglomerular apparatus (via the macula densa cells, which act as baroreceptors; located on the afferent arteriole wall). [6]
Progression of atherosclerosis. A fatty streak is the first grossly visible (visible to the naked eye) lesion in the development of atherosclerosis.It appears as an irregular yellow-white discoloration on the luminal surface of an artery.