Changes in Renal Artery Doppler Indexes Following Renal Angioplasty

Soulen, Michael C.; Benenati, James F.; Sheth, Sheila; Merton, Daniel A.; Rothgeb, Joseph

doi:10.1016/s1051-0443(91)72219-7

Cited by 11 publications

(1 citation statement)

References 13 publications

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“…Although these parameters were measured in the main renal artery, they appear to reflect the resistance and pulsatility downstream at the arteriolar level. Our findings are consistent with studies that used noninvasive Doppler to evaluate intrarenal velocimetric indexes following renal artery revascularization [24, 25, 30, 34]. The magnitude of RI and PI observed in the present study was higher than that observed in other series.…”

Section: Discussionsupporting

confidence: 93%

Correlation between noninvasive and endovascular Doppler in patients with atherosclerotic renal artery stenosis: A pilot study

Slovut

Lookstein

Bacharach

et al. 2006

Cathet Cardio Intervent

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Considerable interest exists in using endovascular techniques for assessing the renal circulation. The vasomotor response of the renal circulation in patients with hypertension and severe atherosclerotic renal artery stenosis was evaluated. Sixteen patients (5 men and 11 women) with a mean age of 73.2+/-7.1 years (range, 59-82 years) underwent noninvasive renal duplex ultrasonography and endovascular flow wire evaluation. The flow wire was positioned in the main renal artery distal to the stenosis and used to examine the reactivity of the renal circulation in response to intra-arterial papaverine before and after percutaneous revascularization. Resistive index was computed as (MPV - EDV)/MPV, where MPV is the maximum peak velocity and EDV is the end-diastolic velocity. Renal flow reserve was defined as the ratio of peak hyperemic response to baseline flow. Intervention was technically successful in 18/18 arteries. Heart rate (69+/-11 vs. 65+/-10 beats/min; P=NS) and systolic blood pressure (168+/-19 vs. 163+/-24 mm Hg; P=NS) remained constant following injection of intrarenal papaverine, while diastolic blood pressure decreased (77+/-13 vs. 65+/-11 mm Hg; P<0.006). Papaverine injection resulted in significant increases in average peak velocity (APV; 148% of baseline; P=0.0003), MPV (146% of baseline; P=0.001), and EDV (161% of baseline; P=0.0026), but had no effect on the endovascular resistive index (0.81+/-0.12 vs. 0.84+/-0.08; P=NS). Renal artery stenting produced no effect on APV or EDV, but a small increase in MPV (123% of baseline; P<0.05). In contrast, renal stenting resulted in a significant increase in the endovascular resistive index (0.77+/-012 vs. 0.84+/-0.08; P=0.003), pulsatility index (1.84+/-0.61 vs. 2.23+/-0.70; P<0.014), and renal flow reserve (1.49+/-0.44 vs. 1.86+/-0.73; P<0.0071). A correlation was found between the noninvasive and endovascular measures diastolic/systolic ratio (r=0.73; P<0.0009) and resistive index (r=0.63; P<0.0053). Patients with atherosclerotic renal artery stenosis have preserved vasomotor response to papaverine, as well as marked increases in renal flow and resistive index following successful renal artery stenting. Endovascular flow wire measurements are safe, easy to perform, and correlate well with noninvasive Doppler measurements.

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