Abstract
This study was aimed at examining whether four intrarenal echo-Doppler velocimetric indices (pulsatility and resistive indices, acceleration and acceleration time) can be useful for assessing the effects of renal artery dilation obtained with either angioplasty or stent implantation. Echo- Doppler studies were performed in 63 hypertensive patients with 68 renal artery stenoses (39 atherosclerotic and 29 fibromuscular) prior to and within five days after the dilation procedures (55 angioplasties, 13 stent implantations), which resulted in an average reduction of arterial narrowing from 79% to 20%. In 24 patients, the velocimetric indices were also examined in relationship to the venoarterial differences of plasma renin activity and of angiotensin II across the stenotic kidneys. We found that after dilation the values of the four indices had returned within the normal range in all but three arteries (one false negative for resistive index and two for acceleration time). However, decrements in acceleration time was the only factor to be significantly correlated with the reduction of arterial narrowing. Moreover, postdilation values of this index were, on average, slightly but significantly higher in arteries that at follow-up developed restenosis rather than in those that remained patent. For similar reductions in arterial narrowing the absolute changes of all indices were similar in atherosclerotic and fibromuscular stenotic arteries and, in a subset of the atheromatous arteries, were also similar after angioplasty and stent implantation. No relationship was found with the changes in the venoarterial differences of plasma renin activity and angiotensin II. It appears that these intrarenal velocimetric indices and, in particular, acceleration time reliably reflect the technical success of renal artery dilation. The acceleration time index may also be valuable for predicting the restenosis of the dilated vessel. None of the indices, however, mirrors the functional consequences of removal of renal artery stenosis as expressed through the changes in transrenal gradients of the components of the renin-angiotensin system.
| Original language | English |
|---|---|
| Pages (from-to) | 1795-1800 |
| Number of pages | 6 |
| Journal | Kidney International |
| Volume | 53 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 1998 |
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Keywords
- Angiotensin II
- Atherosclerotic stenosis
- Fibromuscular renal artery stenosis
- Plasma renin activity
ASJC Scopus subject areas
- Nephrology
Cite this
Effects of balloon angioplasty and stent implantation on intrarenal echo-Doppler velocimetric indices. / Marana, Ivana; Airoldi, Flavio; Burdick, Larry; Alberti, Cristina; Lovaria, Andrea; Saccheri, Silvia; Gazzano, Gabriella; Palatresi, Simone; Nador, Barbara; Turolo, Lucia; Morganti, Alberto.
In: Kidney International, Vol. 53, No. 6, 1998, p. 1795-1800.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of balloon angioplasty and stent implantation on intrarenal echo-Doppler velocimetric indices
AU - Marana, Ivana
AU - Airoldi, Flavio
AU - Burdick, Larry
AU - Alberti, Cristina
AU - Lovaria, Andrea
AU - Saccheri, Silvia
AU - Gazzano, Gabriella
AU - Palatresi, Simone
AU - Nador, Barbara
AU - Turolo, Lucia
AU - Morganti, Alberto
PY - 1998
Y1 - 1998
N2 - This study was aimed at examining whether four intrarenal echo-Doppler velocimetric indices (pulsatility and resistive indices, acceleration and acceleration time) can be useful for assessing the effects of renal artery dilation obtained with either angioplasty or stent implantation. Echo- Doppler studies were performed in 63 hypertensive patients with 68 renal artery stenoses (39 atherosclerotic and 29 fibromuscular) prior to and within five days after the dilation procedures (55 angioplasties, 13 stent implantations), which resulted in an average reduction of arterial narrowing from 79% to 20%. In 24 patients, the velocimetric indices were also examined in relationship to the venoarterial differences of plasma renin activity and of angiotensin II across the stenotic kidneys. We found that after dilation the values of the four indices had returned within the normal range in all but three arteries (one false negative for resistive index and two for acceleration time). However, decrements in acceleration time was the only factor to be significantly correlated with the reduction of arterial narrowing. Moreover, postdilation values of this index were, on average, slightly but significantly higher in arteries that at follow-up developed restenosis rather than in those that remained patent. For similar reductions in arterial narrowing the absolute changes of all indices were similar in atherosclerotic and fibromuscular stenotic arteries and, in a subset of the atheromatous arteries, were also similar after angioplasty and stent implantation. No relationship was found with the changes in the venoarterial differences of plasma renin activity and angiotensin II. It appears that these intrarenal velocimetric indices and, in particular, acceleration time reliably reflect the technical success of renal artery dilation. The acceleration time index may also be valuable for predicting the restenosis of the dilated vessel. None of the indices, however, mirrors the functional consequences of removal of renal artery stenosis as expressed through the changes in transrenal gradients of the components of the renin-angiotensin system.
AB - This study was aimed at examining whether four intrarenal echo-Doppler velocimetric indices (pulsatility and resistive indices, acceleration and acceleration time) can be useful for assessing the effects of renal artery dilation obtained with either angioplasty or stent implantation. Echo- Doppler studies were performed in 63 hypertensive patients with 68 renal artery stenoses (39 atherosclerotic and 29 fibromuscular) prior to and within five days after the dilation procedures (55 angioplasties, 13 stent implantations), which resulted in an average reduction of arterial narrowing from 79% to 20%. In 24 patients, the velocimetric indices were also examined in relationship to the venoarterial differences of plasma renin activity and of angiotensin II across the stenotic kidneys. We found that after dilation the values of the four indices had returned within the normal range in all but three arteries (one false negative for resistive index and two for acceleration time). However, decrements in acceleration time was the only factor to be significantly correlated with the reduction of arterial narrowing. Moreover, postdilation values of this index were, on average, slightly but significantly higher in arteries that at follow-up developed restenosis rather than in those that remained patent. For similar reductions in arterial narrowing the absolute changes of all indices were similar in atherosclerotic and fibromuscular stenotic arteries and, in a subset of the atheromatous arteries, were also similar after angioplasty and stent implantation. No relationship was found with the changes in the venoarterial differences of plasma renin activity and angiotensin II. It appears that these intrarenal velocimetric indices and, in particular, acceleration time reliably reflect the technical success of renal artery dilation. The acceleration time index may also be valuable for predicting the restenosis of the dilated vessel. None of the indices, however, mirrors the functional consequences of removal of renal artery stenosis as expressed through the changes in transrenal gradients of the components of the renin-angiotensin system.
KW - Angiotensin II
KW - Atherosclerotic stenosis
KW - Fibromuscular renal artery stenosis
KW - Plasma renin activity
UR - http://www.scopus.com/inward/record.url?scp=7144235795&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7144235795&partnerID=8YFLogxK
U2 - 10.1046/j.1523-1755.1998.00941.x
DO - 10.1046/j.1523-1755.1998.00941.x
M3 - Article
C2 - 9607215
AN - SCOPUS:7144235795
VL - 53
SP - 1795
EP - 1800
JO - Kidney International
JF - Kidney International
SN - 0085-2538
IS - 6
ER -