Bottom line: There is no data to support percutaneous revascularization for patients with resistant hypertension and significant renal artery stenosis.
Summary: Clinical outcomes after percutaneous revascularization versus medical management in patients with significant renal artery stenosis: a meta-analysis of randomized controlled trials. Am Heart J 2011 Mar;161(3):622-30.
Meta-analysis of 6 RCTs (randomized controlled trials) that assessed percutaneous revascularization with medical therapy as needed compared to medical therapy alone in 1,208 patients (renal artery stenosis ≥ 50%). Did not assess quality of RCTs. RESULTS: Found no significant differences between the two groups in all-cause mortality, heart failure, stroke, worsening renal function (≥ 20% decrease in estimated creatinine clearance or ≥ 50% increase in serum creatinine), systolic and diastolic blood pressure, or serum creatinine. Fig. 3 (p. 627) displays forest plots pooling data on mortality, CHF and worsening renal failure for the six trials.