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A transstenotic pressure gradient is needed to reduce renal perfusion and to activate the renin\u2010angiotensin\u2010aldosterone system. In only a minority of patients included in trials, a transstenotic pressure gradient is measured and reported. Like the coronary circulation, integration of physiological lesion assessment will allow to avoid stenting of non\u2010significant lesions and select those patients that are most likely to benefit from renal artery stenting. Renal artery interventions are associated with peri\u2010procedural complications. Contemporary techniques, including radial artery access, no\u2010touch technique to engage the renal ostium and the use of embolic protection devices, will minimize procedural risk. Combining optimal patient selection and meticulous technique might lead to a netto clinical benefit when renal artery stenting is added to optimal medical therapy.<\/jats:p>","DOI":"10.1002\/ccd.31117","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T12:45:17Z","timestamp":1717505117000},"page":"285-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interventions for renal artery stenosis: Appraisal of novel physiological insights and procedural techniques to improve clinical outcome"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6960-5572","authenticated-orcid":false,"given":"Benny","family":"Drieghe","sequence":"first","affiliation":[{"name":"Heart Center, University Hospital Gent Gent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"De 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