Renal Artery Stents for the Treatment of Severe Hypertension

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    UJU@H6 Whom` Mwuhwz Quhouq diw uch Uwhmukhou id Qhthwh Cz~hwuhoqjio

    MXUCIW6 Fxejuc Rm`qc, KE, K^C

    ^widhqqiw id Khejajoh

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    Eh~mwukhou id Khejajoh

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    ^XG@JQCHW6 Am`jdiwojm Uhacoi`ibz Mqqhqqkhou Diwxk

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    ^@MAH ID ^XG@JAMUJIO6 Qmo Dwmoajqai, AM

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    WHOM@ MWUHWZ QUHOUQ DIW QHTHWH CZ^HWUHOQJIOM Uhacoi`ibz Mqqhqqkhou

    JOUWIEXAUJIO

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    htjehoah diw uch xqh id whom` mwuhwz quhouq diw uch uwhmukhou id qhthwh cz~hwuhoqjio/ Ucjq jq uch djwqu

    ujkh ucmu AUMD cmq meewhqqhe ucjq ui~ja/

    GMALBWIXOE

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    cmth CUO/= Uch joajehoah id CUO joawhmqhq rjuc mbh moe uch kmfiwjuz id joejtjexm`q ithw mbh 48

    cmth CUO/

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    M ejmboiqjq id CUO jq kmeh gmqhe io uch mthwmbh id uri iw kiwh whmejobq mu hmac id uri iw kiwhtjqjuq mduhw mo jojujm` qawhho/7

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    joejtjexm`q jq dixoe ui cmth qhaioemwz CUO rcjac jq amxqhe gz mo xoehw`zjob aioejujio/ Mo

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    xoehw`zjob amxqh id uch CUO qcix`e gh aioqjehwhe jo joejtjexm`q rci cmth whqjqumou iw ejddjax`u ui

    aiouwi` CUO moe jo joejtjexm`q rci ~whqhou rjuc CUO mu m zixob mbh/

    Uch joajehoah id whom` mwuhwz quhoiqjq mq m amxqh id CUO jq `ir jo ~wjkmwz CUO, gxu jo whqjqumou

    cz~hwuhoqjio, uch joajehoah jq hqujkmuhe ui gh mq cjbc mq =>+5>(/1 Uch uri kmfiw amxqhq id whom`

    mwuhwz quhoiqjq mwh muchwiqa`hwiqjq moe djgwikxqax`mw ezq~`mqjm/ Muchwiqa`hwiqjq jq kiwh aikkio

    jo kho moe uch joajehoah joawhmqhq rjuc mbh/ Ju jq kiwh iduho ohmw uch miwuja iwjdjah iw uch ~wisjkm`

    whom` mwuhwz/ Ju jq m`qi kiwh aikkio jo joejtjexm`q rjuc muchwiqa`hwiuja ejqhmqh h`qhrchwh/5

    Djgwikxqax`mw ezq~`mqjm jq kiwh aikkio jo rikho mbhe 8> moe zixobhw moe uhoeq ui mddhau uch

    ejqum` whom` mwuhwz iw uch jouwmwhom` gwmoachq/

    Uch ejmboiqjq id whom` mwuhwz quhoiqjq jq kmeh gz tmqax`mw jkmbjob moe a`jojam``z qjbojdjamou hqjioq

    mwh bhohwm``z ehdjohe mq uciqh cmtjob m quhoiqjq id ?28(/ Uch ucwhh ~iuhoujm` uwhmukhou i~ujioq

    diw whom` mwuhwz quhoiqjq mwh khejam` uchwm~z, ~hwaxumohixq mobji~`mquz rjuc iw rjucixu quhou

    ~`mahkhou iw qxwbhwz/ M`ucixbc khejam` uwhmukhou jq uch xqxm` jojujm` m~~wimac, uchwh mwh qikh

    ~iuhoujm` aioahwoq rjuc khejam` uwhmukhou/ Uchqh joa`xeh ~wibwhqqjio id uch quhoiqjq, jk~mjwhe

    ljeohz dxoaujio mduhw mobjiuhoqjo jocjgjujio moe jqachkja emkmbh ui uch quhoiuja ljeohz/

    ^wibwhqqjio id uch quhoiqjq amo `hme ui ljeohz dmj`xwh moe jq kiwh aikkio jo uciqh rjuc gj`muhwm`

    quhoiqjq/ ^hwqjquhou qhthwh quhoiqjq amo whqx`u jo m `iqq id whom` kmqq/8 Whom` dxoaujio amo

    eha`joh, hq~hajm``z rjuc uch xqh id mobjiuhoqjo aiothwujob hovzkh jocjgjuiwq/4

    Uwhmukhou id cz~hwuhoqjio exh ui whom` mwuhwz quhoiqjq6 Bhohwm``z uch ~wjkmwz uwhmukhou jq khejam`

    uwhmukhou id uch CUO/ Jojujm` uwhmukhou joa`xehq oio~cmwkmai`ibja khmqxwhq moe qxgqh}xhou

    uwhmukhou joti`thq ~cmwkmai`ibja khmqxwhq rjuc m tmwjhuz id khejamujioq xqhe joejtjexm``z moe jowhtmqax`mwjvmujio hjuchw gz mobji~`mquz iw gz qxwbhwz jq uz~jam``z aioqjehwhe jd khejam` uchwm~z jq

    johddhaujth/ Uch bim`q id whtmqax`mwjvmujio uchwm~z mwh ui jk~with g`iie ~whqqxwh moe ui qumgj`jvh

    iw jk~with whom` dxoaujio/

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    ^hwaxumohixq uwmoq`xkjom` whom` mobji~`mquz #^UWM* rjuc quhoujob jq m hqq jotmqjth ~wiahexwh

    ucmo qxwbhwz/ Uch bim` jq ui jk~with thqqh` ~muhoaz, moe jk~with qikh id uch ~czqji`ibja

    acmobhq ucmu whqx`u dwik whom` mwuhwz quhoiqjq moe aiouwjgxuh ui CUO/ Exwjob mobji~mquz id uch

    whom` mwuhwz, m amuchuhw jq joqhwuhe moe kithe ui uch qjuh id uch quhoiqjq/ Ucho m gm``iio jq jod`muhe

    ui jk~with thqqh` ~muhoaz/ Rjuc quhoujob, m quhou #xqxm``z kmeh id qumjo`hqq quhh`* jq ucho joqhwuhe

    joui uch qjuh jo ci~hq id lhh~job uch thqqh` i~ho/ Axwwhou`z uch tmqu kmfiwjuz id ^UWM ~wiahexwhq

    mwh eioh rjuc quhoujob/

    Jd whtmqax`mwjvmujio jq aioqjehwhe, mo jk~iwumou }xhqujio jq rcmu uch wh`htmou ixuaikh jq/ Jehm``z,

    quxejhq meewhqqjob uch uwhmukhou id CUO qcix`e meewhqq rchuchw iw oiu uwhmukhou id uch CUOwhexahq kiwum`juz iw ~whthouq iuchw amwejitmqax`mw hthouq qxac mq kziamwejm` jodmwaujio iw quwilh/

    Cirhthw, quxejhq meewhqqjob uchqh ixuaikhq ohhe ui gh mwbh rjuc m `iob exwmujio id di``ir+x~/

    ^mwujax`mw`z jo uch wh`mujth`z qkm`` ~i~x`mujio id joejtjexm`q rci cmth whom` mwuhwz quhoiqjq mq m

    amxqh diw uchjw CUO, quxejhq id ucjq kmbojuxeh kmz oiu gh dhmqjg`h/

    G`iie ~whqqxwh whexaujio jq iduho xqhe mq m qxwwibmuh ixuaikh, qjoah whexaujio jo g`iie ~whqqxwh

    cmq ghho mqqiajmuhe rjuc qjbojdjamou a`jojam` ixuaikhq/ Jo a`jojam` uwjm`q moujcz~hwuhoqjth uchwm~z

    cmq ghho mqqiajmuhe rjuc whexaujioq jo quwilh id 18+5>( moe m whexaujio jo kziamwejm` jodmwaujio id

    7>+78(/2 Ju cmq ghho hqujkmuhe ucmu jo ~mujhouq rjuc qumbh = CUO #QG^ =5>+=8: moe)iw EG^ :>+::

    kk Cb* moe meejujiom` amwejitmqax`mw wjql dmauiwq, macjhtjob m =7 kkCb whexaujio jo G^ ucmu jq

    qxqumjohe diw => zhmwq aix`e ~whthou ioh ehmuc ~hw hthwz == ~mujhouq uwhmuhe/3Moiuchw a`jojam``z

    wh`htmou ixuaikh jq ~wibwhqqjio id whom` ejqhmqh/

    Qikh id uch hmw`z quxejhq id whtmqax`mwjvmujio diaxqhe io mobji~`mquz rjucixu quhou ~`mahkhou/

    Axwwhou`z, jd mobji~`mquz jq ~hwdiwkhe, m quhou jq m`kiqu m`rmzq ~`mahe xo`hqq uch momuikz id uchthqqh` eihq oiu m``ir quhou ~`mahkhou/ Ucjq mqqhqqkhou diaxqhq io uch xqh id mobji~`mquz jo

    aiofxoaujio rjuc quhou ~`mahkhou diw uch uwhmukhou id qhthwh cz~hwuhoqjio/

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    UM Awjuhwjio =6 Uch uhacoi`ibz kxqu cmth djom` m~~witm` dwik uch m~~wi~wjmuh bithwokhou

    whbx`muiwz giejhq/

    Whom` quhouq mwh DEM A`mqq 1 ehtjahq rjuc ^wiexau Aieh OJO/ Uchwh mwh djth whom` quhou qzquhkq

    m~~withe gz uch DEM/

    ^wiexau omkh Kmoxdmauxwhw DEM ^KMm~~witm`

    Kmuhwjm`

    WS Chwax`jol H`juh Whom` Quhou Qzquhk Mggiu 7>== Aigm`u acwikjxk

    Diwkx`m 5=5WS Gm``iio Hs~moemg`hWhom` Quhou moe uch Diwkx`m 5=3Gm``iio Hs~moemg`h Whom` Quhou

    Aiil Khejam` 7>== Qumjo`hqq quhh`

    Hs~whqq QE Whom` Kioiwmj`^whkixouhe Quhou Qzquhk

    Giquio Qajhoujdja 7>>3 Qumjo`hqq quhh`

    ^M@KMV Gm``iio+Hs~moemg`h Quhoudiw Whom` Mwuhwjhq

    Aiwejq 7>>7 Qumjo`hqq quhh`

    Gwjebh Hsuwm Qx~~iwu Ithw+Uch+RjwhWhom` Quhou Qzquhk

    Kheuwioja 7>>7 Qumjo`hqq quhh`

    Mggiuu rj`` gh di``irjob uch hsjqujob 7>7 ~mujhou CHWAX@HQ quxez aiciwu diw m uium` id ucwhh zhmwq

    ui mqqhqq uch iob uhwk qmdhuz moe hddhaujthohqq id uch WS Chwax`jol H`juh Whom` Quhou Qzquhk/

    UM Awjuhwjio = jq khu

    UM Awjuhwjio 76 Uch qajhoujdja htjehoah kxqu ~hwkju aioa`xqjioq aioahwojob uch

    hddhaujthohqq id uch uhacoi`ibz whbmwejob chm`uc ixuaikhq/

    Uch Khe`joh emumgmqh, Aiacwmoh a`jojam` uwjm`q emumgmqh, Aiacwmoh whtjhrq emumgmqh moe

    Emumgmqh id Mgquwmauq id Whtjhrq id Hddhauq #EMWH* rhwh qhmwache xqjob uch qhmwac uhwkq

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    gjg`jibwm~cjhq id qzquhkmuja whtjhrq moe lhz mwuja`hq rhwh kmoxm``z qhmwache diw meejujiom`

    whdhwhoahq moe whdhwhoahq rhwh wh}xhquhe dwik ehtjah kmoxdmauxwhwq/ Uch mgquwmauq id ajumujioq

    rhwh whtjhrhe diw wh`htmoah moe m`` ~iuhoujm``z wh`htmou mwuja`hq rhwh whtjhrhe jo dx``/

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    Joa`xqjio awjuhwjm diw juhwmuxwh whtjhr aioqjehwmujio rhwh6

    Quxez cme ui htm`xmuh whom` mwuhwz quhoujob jo ~mujhouq rjuc whom` mwuhwz quhoiqjq moe CUO

    Quxez cme ui gh ~wiq~haujth

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    Joa`xehe io`z cxkmoq

    ^xg`jqche jo Hob`jqc mq m ~hhw whtjhrhe mwuja`h

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    uchz rhwh whuwiq~haujth/

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    hsa`xehe diw oiu meewhqqjob uch whqhmwac }xhqujio/ M uium` id 1= mgquwmauq rhwh htm`xmuhe/ 77 rhwh

    hsa`xehe/ Whmqioq diw hsa`xqjio joa`xehe oiu wh~iwujob a`jojam` ixuaikhq, oiu ghjob ~wiq~haujth,

    iw oiu aik~mwjob whom` mwuhwz quhoujob rjuc khejam` uwhmukhou/ Id uchqh, dixw ~xg`jqche

    ~wiq~haujth quxejhq moe djth a`jojam` uwjm`q mwh joa`xehe jo ucjq htm`xmujio/

    Ehumj`q id uch igqhwtmujiom` quxejhq mwh ehqawjghe jo Umg`hq = moe 7/ Ehumj`q id uch a`jojam` uwjm`q

    moe uch ixuaikhq khmqxwhe mwh ehqawjghe jo Umg`h 1/ A`jojam` uwjm`q moe uch ixuaikhq khmqxwhe

    mwh ehqawjghe jo Umg`h 1 moe 5/ Uchwh rhwh dixw ~wiq~haujth igqhwtmujiom` quxejhq moe djth a`jojam`

    uwjm`q/

    M`ucixbc uch ixuaikhq tmwjhe mkiob uch quxejhq, uz~jam` ixuaikhq joa`xehe uch g`iie ~whqqxwh

    ghdiwh moe mduhw uwhmukhou, oxkghw id mouj+cz~hwuhoqjth khejamujioq wh}xjwhe, moe khmqxwhq id

    whom` dxoaujio qxac mq awhmujojoh/ Oi quxejhq cmth mqqhqqhe uch jk~mau id whom` mwuhwz quhoujob io

    uch jk~iwumou ixuaikhq id kiwum`juz, amwejitmqax`mw ixuaikhq iw ~wibwhqqjio ui ejm`zqjq/

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    @hth` id Htjehoah6 =, 1

    UM Awjuhwjio 7 jq khu

    UM Awjuhwjio 16 Uch uhacoi`ibz kxqu jk~with ohu chm`uc ixuaikhq/

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    rjuc dhr ohbmujth hddhauq/ M`ucixbc kmoz whuwiq~haujth quxejhq cmth wh~iwuhe io uch ixuaikhq id

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    jo Umg`h 7/

    Uri hmw`z quxejhq aioexauhe jo Bwhhah moe Mxquwjm cme `hqq ucmo =>> ~mujhouq hmac/ :,=> Di``ir+x~

    wmobhe dwik 73 kioucq ui 52/8 kioucq/ Giuc quxejhq wh~iwuhe ghuuhw g`iie ~whqqxwh aiouwi` rjuc

    whtmqax`mwjvmujio moe quhoujob moe wh~iwuhe ucmu ^UWM m~~hmwhe qmdh/

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    giuc qzqui`ja moe ejmqui`ja g`iie ~whqqxwhq cme qjbojdjamou`z ehawhmqhe moe uch oxkghw id

    moujcz~hwuhoqjth khejamujioq wh}xjwhe cme ehawhmqhe dwik gmqh`joh #7/> tq/ 7/56 0>/>8*/ Qhwxk

    awhmujojoh cme m`qi ehawhmqhe ithw uch dixw zhmwq id di``ir x~ #=/2 ui =/16 ^0>/>8*/:

    Jo uch MQ^JWH+7 quxez, m X/Q/ kx`uj+ahouhw quxez jo ~mujhouq jo rcik jojujm` ^UWM rmqxoqxaahqqdx`, 7>3 ~mujhouq rhwh di``irhe diw 75 kioucq/ Uch ~wjkmwz ixuaikh rmq wmuh id

    whquhoiqjq rcjac rmq =2/5( mu : kioucq/ Qzqui`ja g`iie ~whqqxwh rmq ehawhmqhe dwik =43 ui =5:

    #^0>/>>=*/ Khmo qhwxk awhmujojoh whkmjohe xoacmobhe dwik gmqh`joh, gxu uchwh rmq m axkx`mujth

    joajehoah id kmfiw methwqh hthouq id =:/2(/ Qjoah ucjq quxez io`z joa`xehe ~mujhouq rci cme m

    dmj`he UWM, juq bhohwm`jvmgj`juz jq jkjuhe/

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    ^iuhoujm` Ghohdjuq

    Uch kmjo ~iuhoujm` ghohdju rix`e gh m whexaujio jo kiwum`juz iw iuchw amwejitmqax`mw ixuaikhq iw

    whexaujio jo hoe qumbh whom` ejqhmqh, gxu ui emuh oi quxejhq cmth htm`xmuhe uch jk~mau id UWM io

    uchqh a`jojam` ixuaikhq/ Jouhwkhejmuh ixuaikhq rix`e joa`xeh jk~withkhou jo g`iie ~whqqxwh

    aiouwi` moe jk~withkhou jo whom` dxoaujio/ Mq ehqawjghe mgith, ~wiq~haujth igqhwtmujiom` quxejhq

    cmth qciro jk~withkhou jo g`iie ~whqqxwh aiouwi` moe jo whom` dxoaujio mq khmqxwhe gz eha`joh jo

    qhwxk awhmujojoh rjuc di``ir+x~ x~ ui dixw zhmwq/ Uch jk~mau id uch jk~withe g`iie ~whqqxwh aiouwi`

    io a`jojam` ixuaikhq qxac mq amwejitmqax`mw kiwgjejuz moe kiwum`juz jq oiu loiro/

    ^iuhoujm` Wjqlq

    ^iuhoujm` wjqlq mqqiajmuhe rjuc mobji~`mquz moe quhou ~`mahkhou mwh kiqu`z wh`muhe ui ~wiahexwm`

    aik~`jamujioq/ Uch wmuh id ~wiahexwm` aik~`jamujioq diw ^UWM rjuc iw rjucixu quhoujob jq ghurhho 8

    moe =8 ~hwahou/==+=4Uch kiqu aikkio iohq mwh ~xoauxwh qjuh chkmuikm moe whom` mwuhwz

    ejqqhaujio/ Iuchw ~iuhoujm` aik~`jamujioq mwh mwuhwz ucwikgiqjq iw ~hwdiwmujio, maxuh ljeohz

    ejqhmqh exh ui muchwihkgi j moe wmejiaiouwmqu mbhou whmaujio/

    Jo uch MQUWM@ quxez, m WAU ehqawjghe gh`ir, =: id uch 13 aik~`jamujioq ucmu iaaxwwhe rjucjo 75

    cixwq id uch ~wiahexwh rhwh qhwjixq methwqh hthouq+ djth whom` mwuhwz hkgi`jvmujioq, dixw whom`

    mwuhwjm` iaa`xqjioq, dixw whom` mwuhwz ~hwdiwmujioq, ioh dhkiwm` mwuhwz mohxwzqk, ~x`kiomwz hehkm,

    kziamwejm` jodmwaujio #KJ* moe ucwhh rjuc aci`hquhwi` hkgi`j/

    M kmfiw aioahwo jq uch ~iqqjgj`juz id amxqjob ejqum` hkgi`j id uch muchwiqa`hwiuja ucwikgxq/M`ucixbc uch ~wiahexwh jq iduho ~hwdiwkhe xqjob ejqum` hkgi`ja ~wiuhaujio, uch jk~mau id ucjq

    ~wmaujah jq oiu axwwhou`z loiro/

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    Qxkkmwz

    Jo qxkkmwz, qhthwm` ~wiq~haujth quxejhq cmth htm`xmuhe UWM rjuc quhou diw uch uwhmukhou id whom`

    mwuhwz quhoiqjq/ ^UWM rjuc quhou m~~hmwq ui gh hddjamajixq jo whexajob g iie ~whqqxwh moe uch

    ohhe diw g`iie ~whqqxwh khejamujioq mu uri ui dixw zhmw di``ir+x~/ Uchwh jq uch ~iuhoujm` diw

    methwqh hthouq, hq~hajm``z uciqh wh`muhe ui uch ~wiahexwh/

    M`ucixbc ju jq ejddjax`u ui rhjbc uch ghohdjuq moe wjqlq, ^UWM rjuc quhou ehdjojuh`z cmq uch ~iqqjgj`juz

    id jk~witjob g`iie ~whqqxwh aiouwi` moe jk~witjob whom` dxoaujio mu `hmqu jo uch qciwu uhwk, moe ucxq

    amo jk~with ohu chm`uc ixuaikhq/

    UM Awjuhwjio 1 jq khu/

  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

    11/25

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

    12/25

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

    13/25

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

    14/25

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

    16/25

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  • 8/2/2019 Renal Artery Stents for the Treatment of Severe Hypertension

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    WHAIKKHOEMUJIO

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    WHAIKKHOEMUJIO ID IUCHWQ

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    Mkhwjamo Ai``hbh id Amweji`ibz #MAA*

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    http://content.onlinejacc.org/cgi/content/full/47/6/e1http://content.onlinejacc.org/cgi/content/full/47/6/e1http://content.onlinejacc.org/cgi/content/full/47/6/e1http://content.onlinejacc.org/cgi/content/full/47/6/e1
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    Qiajhuz id Jouhwthoujiom` Wmeji`ibz #QJW*

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    MGGWHTJMUJIOQ XQHE JO UCJQ MQQHQQKHOU6

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