International Circulation: I believe studies done to date have not shown a large amount of difference between medical therapy and stenting.
　　Dr de Leeuw: That is correct. But look at the types of patients that were included in those studies. They all had high-grade stenosis and their creatinine levels were all elevated， so the patients that were included in these studies were the ones who already had well-advanced disease and must have had considerable intrarenal damage. That is my point; these are the kinds of patients you don’t want to have because they already have so much damage that there is little to gain and that is exactly what the trials are showing. I think the pathophysiological concept that lead to these trials is basically wrong.
　　《国际循环》：据我所知到目前为止还没有研究显示肾动脉狭窄的药物治疗和支架治疗之间存在显著差异。
　　Dr de Leeuw:你说的对。但是看看这些试验中入选的患者类型，那些患者的动脉狭窄程度都较重并且肌酐水平都升高，所以这些试验中纳入的患者都是晚期病变的患者并且合并相当大程度的肾脏损害。这就是我的观点。这些患者是我们不希望进行试验的患者，因为他们已经有很多损害以至于治疗后获益有限，同时这也确实是这些试验所得到的结果。我认为引导这些试验的病理生理概念是根本错误的。
　　International Circulation: Your thinking is that if you put a stent in there early on you can prevent the build-up of plaque and maintain a healthier artery?
　　Dr de Leeuw: Yes and it is at least worthwhile exploring in a formal trial.
　　《国际循环》：您的观点那是如果在早期就植入支架就能阻止病变的继续进展并使动脉更健康？
　　Dr de Leeuw： 对，至少这种观点值得在正式的试验中进行验证。
　　International Circulation: You don’t use ultrasound in your screening procedure at all?
　　Dr de Leeuw: It is not very sensitive and very operator-dependent. Of course you can standardize a lot of things but it is still not reliable enough and many laboratories have problems with it.
　　《国际循环》：在您筛选患者的过程中从来不用超声检查吗？
　　Dr de Leeuw:超声并不十分敏感而且每个检查操作者之间的差异非常大。当然你可以规范化这个检查的很多方面但是它仍然不是很可靠的方法，并且很多医院的这项检查都存在一些问题。
　　International Circulation: So with the CTA and the MRA you would use the CTA because it is more sensitive than the MRA.
　　Dr de Leeuw: Correct
　　《国际循环》：所以在CTA 和MRA之间您会选择CTA，因为它比MRA要敏感的多是吗？
　　Dr de Leeuw: 非常正确。
　　International Circulation: And you use digital subtraction angiography (DSA) as opposed to conventional angiography?
　　Dr de Leeuw:  Yes
　　《国际循环》：并且您会使用数字剪影血管造影(DSA)而不是传统的血管造影术是吗？
　　Dr de Leeuw：对。