Revascularization for Renovascular Disease: A Scientific Statement from the American Heart Association

Vivek Bhalla, Stephen C. Textor, Joshua A. Beckman, Ana I. Casanegra, Christopher J. Cooper, Esther S.H. Kim, James M. Luther, Sanjay Misra, Gustavo S. Oderich

Research output: Contribution to journalReview articlepeer-review


Renovascular disease is a major causal factor for secondary hypertension and renal ischemic disease. However, several prospective, randomized trials for atherosclerotic disease failed to demonstrate that renal revascularization is more effective than medical therapy for most patients. These results have greatly reduced the generalized diagnostic workup and use of renal revascularization. Most guidelines and review articles emphasize the limited average improvement and fail to identify those clinical populations that do benefit from revascularization. On the basis of the clinical experience of hypertension centers, specialists have continued selective revascularization, albeit without a summary statement by a major, multidisciplinary, national organization that identifies specific populations that may benefit. In this scientific statement for health care professionals and the public-at-large, we review the strengths and weaknesses of randomized trials in revascularization and highlight (1) when referral for consideration of diagnostic workup and therapy may be warranted, (2) the evidence/rationale for these selective scenarios, (3) interventional and surgical techniques for effective revascularization, and (4) areas of research with unmet need.

Original languageEnglish (US)
Pages (from-to)E128-E143
Issue number8
StatePublished - Aug 1 2022


  • AHA Scientific Statements
  • heart failure
  • hypertension, renovascular
  • renal artery obstruction

ASJC Scopus subject areas

  • Internal Medicine


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