Abstract: FR-PO383
The Minimal Diameter of Renal Artery Stenosis but Not Percentage Diameter Reduction Is Associated with Kidney Perfusion and Function
Session Information
- Hypertension and CVD: Basic
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1601 Hypertension and CVD: Basic
Authors
- Lubas, Arkadiusz, Wojskowy Instytut Medyczny - Panstwowy Instytut Badawczy, Warszawa, Mazowieckie, Poland
- Grzywacz, Anna, Wojskowy Instytut Medyczny - Panstwowy Instytut Badawczy, Warszawa, Mazowieckie, Poland
- Zegadlo, Arkadiusz, Wojskowy Instytut Medyczny - Panstwowy Instytut Badawczy, Warszawa, Mazowieckie, Poland
- Niemczyk, Stanislaw, Wojskowy Instytut Medyczny - Panstwowy Instytut Badawczy, Warszawa, Mazowieckie, Poland
Background
Renal Artery Stenosis (RAS) exceeding 50% of the lumen diameter is considered hemodynamically significant. Refractory hypertension or declining kidney function coexistence can contribute to invasive treatment. However, the different diameters of supplying arteries result in different diameters of stenoses, although they all can be estimated at 50% of the lumen diameter reduction. Thus, different diameters of stenoses can be improperly qualified for revascularization on the same decision level. The study aimed to investigate which parameter of Renal Artery Stenosis is associated with kidney perfusion and function.
Methods
Forty kidneys with single, non-hypoplastic supplying arteries were evaluated in a contrast-enhanced multidetector computed tomography (GE Discovery 750 HD) in 25 patients (11F, 14M; age 62 ±16) with hypertension and RAS suspicion. The minimal diameter (MD), percentage of diameter reduction (DR), and lumen cross-sectional area reduction (CSAR) of narrowed renal arteries, renal parenchymal blood flow (RPBF), and kidney function (CKD-EPI) were estimated.
Results
The mean values of investigated parameters were evaluated: MD 2.91 ±1.23 mm; DR 38.8 ±15.2 (range 5-73) %; CSAR 53.7 ±19.0 %; RPBF 187.7 mL/s/100g; CKD-EPI 57.9 ±29.7 ml/min/1.73 m2. In correlation analysis, only MD was significantly associated with RPBF (r=0.377, p=0.016) and CKD-EPI (r=0.346; p=0.029), whereas DR was not correlated with these parameters (r=-0.134, p=0.410, and r=-0.229; p=0.156, respectively), and CSAR was significantly connected only with CKD-EPI (r=-0.290, p=0.070, and r=-0.335, p=0.035; respectively).
Conclusion
The absolute value of Renal Artery Stenosis minimal diameter is more closely associated with kidney perfusion and function than percentage values of diameter and lumen cross-sectional area reduction. Implementing the minimal diameter of stenosis in the renal artery revascularization criteria could improve the effectiveness of this procedure.
Funding
- Government Support – Non-U.S.