Afghanistan Comprehensive Specialization Exam Practice Questions - Afghanistan Comprehensive Specialization Completion Exam (Takhasus) Exam

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A 28-year-old previously healthy woman presents with refractory hypertension (blood pressure 178/104 mmHg despite dual-agent antihypertensive therapy) and an unprovoked sudden right-sided pulsatile tinnitus. Physical examination reveals an epigastric systolic-diastolic vascular bruit and a right carotid bruit. Serum creatinine is 0.9 mg/dL and serum potassium is 3.4 mEq/L. Computed tomography angiography (CTA) of the renal and carotid arteries reveals bilateral alternating areas of arterial stenosis and aneurysmal dilation described as a 'string of beads' primarily involving the middle and distal segments of the renal arteries. What is the most definitive primary interventional therapy of choice for her renal vascular pathology?

Surgical renal revascularization with saphenous vein aortorenal bypass graft Percutaneous balloon angioplasty (PTRA) without routine primary stent placement Catheter-directed renal artery stenting with drug-eluting stents Radiofrequency catheter-based bilateral renal sympathetic denervation

Correct Answer:

Percutaneous balloon angioplasty (PTRA) without routine primary stent placement

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