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.

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肾血管疾病的血运重建：美国心脏协会的科学声明

肾血管疾病是继发性高血压和肾缺血性疾病的主要致病因素。然而，几项针对动脉粥样硬化疾病的前瞻性随机试验未能证明对于大多数患者而言，肾血运重建术比药物治疗更有效。这些结果大大减少了肾血运重建的一般诊断检查和使用。大多数指南和评论文章都强调平均改善有限，并且未能识别那些确实受益于血运重建的临床人群。根据高血压中心的临床经验，专家们继续进行选择性血运重建，尽管没有一个主要的多学科国家组织的总结声明来确定可能受益的特定人群。在这份针对医疗保健专业人员和广大公众的科学声明中，我们回顾了血运重建随机试验的优点和缺点，并强调（1）何时可能需要转诊考虑诊断检查和治疗，（2）证据/这些选择性方案的理由，(3) 有效血运重建的介入和手术技术，以及 (4) 需求未得到满足的研究领域。