When to suspect it
- Blood pressure needing three or more medicines to control
- Kidney function worsening after starting an ACE inhibitor or ARB
- A sudden rise in blood pressure in someone previously well controlled
- Repeated episodes of fluid on the lungs without a cardiac cause
Treatment
Duplex ultrasound and CT angiography confirm the diagnosis. Many patients do best on medication alone; where intervention is warranted, angioplasty and stenting are performed through a small puncture, with open or hybrid reconstruction reserved for complex anatomy.
