HOW TO DIAGNOSE RENAL ARTERY STENOSIS?
Various tests have been tried and improvised to achieve the status of an “ideal” screening test that would be non-invasive, safe, easy to perform, widely accessible, reproducible and highly accurate. Unfortunately to date no test has yet been devised that meets all these criteria. So how should one work up a patient with suspected RAS? Once the decision is made to pursue an evaluation for renovascular hypertension, one or more of the multiple imaging and physiological tests may be used. It is difficult to recommend a single rigid diagnostic algorithm for all patients, due to the variability of clinical conditions and with the imprecise studies presently available; the evaluation is usually tailor-made for each patient. 1. Rapid sequence intravenous urogram Rapid sequence urogram was widely accepted as a screening method for renovascular hypertension in the past. [8] This technical modification of the intravenous urogram uses films exposed at 1,2,3 and 5 minutes after contrast injection
