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Randomised trials show that renal artery angioplasty based on angiographic qualification is not beneficial in improving blood pressure, renal function or mortality. At the same time, recent studies have indicated that trans-lesional pressure gradient measurement might help to identify patients in whom percutaneous renal revascularisation would have a favourable effect in terms of hypertension improvement. We present a case of a 53-year-old woman with unilateral renal artery stenosis and resistant hypertension in whom successful fractional flow reserve guided renal artery stenting was performed.

Fractional flow reserve guided renal artery angioplasty – a new method of optimal patient selection?