Advances in endovascular treatment of renal artery stenosis

Renal artery stenosis (RAS) is a significant cause of secondary hypertension and renal insufficiency. With the rapid advancement of endovascular techniques, endovascular therapy has become the mainstream modality for RAS revascularization. This article systematically reviews the etiology and pathophysiology of RAS, elaborates on the principles, clinical application status, and efficacy of emerging endovascular techniques, including percutaneous transluminal renal angioplasty, stent placement, drug-coated balloons, chocolate balloons, and covered stents. It summarizes the value of imaging diagnosis and functional assessment in preoperative screening and evaluates postinterventional outcomes regarding blood pressure improvement, renal function changes, restenosis, and complications. Finally, it discusses clinically controversial issues such as the timing of intervention and selection of benefiting populations, and provides an outlook on future technological directions. This article reviews the current evidence and identifies key knowledge gaps, with the aim of informing clinical decision-making and highlighting promising directions for future research.