Renal Artery Stenosis and Evaluation of the Effect of Endoluminal Dilatation: Comparison of Dynamic CT Scanning and I-131-OIHA Renogram

Probst, Peter; Mahler, F; Roesler, Hélio; Wa, Fuchs

doi:10.1097/00004424-198305000-00009

Cited by 9 publications

(6 citation statements)

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“…However, no definitive conclusions on this point can be drawn from this study because no repeated control angiographies or functional studies other than the renograms after PTA have been done in the patients with renographic improve ment but with failure or only improvement of their blood pressure after PTA. Probstet al [5] compared the relative function of the poststenotic kidney in the Ol H renogram with that in dynamic CT scanning before and after PTA. As in our study, he found improvement of the RHU after PTA in the group of patients with a favorable blood pres sure response, which did correspond with an increase of the relative opacification in the CT scanning.…”

Section: Discussionmentioning

confidence: 99%

Renography: Prediction of Blood Pressure after Dilatation of Renal Artery Stenosis

Geyskes¹,

Oei²,

Faber³

1986

Nephron

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In 60 patients with hypertension and unilateral renal artery stenosis (URAS) radio-hippuran renograms were performed before and 6 weeks after anatomically adequate percutaneous transluminal angioplasty (PTA). Two characteristics of the renographic curves have been analyzed: the difference in time to peak (DTP) between the affected and contralateral kidneys, which would be expected to be positive in blood flow impairment, and the relative hippuran uptake (RHU) in the second minute by the affected kidney as compared with the total uptake by both kidneys: this would be less than 50% in the case of stenosis. Before PTA, both variables were predominantly abnormal. The DTP did not predict the blood pressure response to PTA. The group of patients with a RHU between 25 and 45% comprised all cured patients and predicted a more favorable response of the blood pressure than a RHU of less than 25% and especially more than 45% which group contained 83% patients whose blood pressure failed to respond after PTA. After PTA the DTP did normalize in the majority of patients, but this was not related to the blood pressure response. The RHU increased in patients in whom it had been low initially, but frequently remained low ( < 45%). The increase of the RHU was significantly higher in patients with a favorable blood pressure response. Pretreatment with captopril did intensify the abnormal curves of hippuran and of DTPA renograms in 6 patients with URAS who did respond favorably to PTA. There was no such deterioration in 2 patients whose blood pressure did not change sufficiently after PTA or in 4 patients without renal artery stenosis. In conclusion, renography can to some extent predict the effect of PTA on the blood pressure; possibly captopril pretreatment can improve its predictive ability. Sequential renographies can be used as an indication of improvement of the renal function after PTA.

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Section: Discussionmentioning

confidence: 99%

Renography: Prediction of Blood Pressure after Dilatation of Renal Artery Stenosis

Geyskes¹,

Oei²,

Faber³

1986

Nephron

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“…The potential role of computed tomography in the detection of renal ischemia has been evaluated by several investigators in animals (14,29,36) and in humans (19,28,34,35). Whereas all investigators agree on the capability of CT to demonstrate renal ischemia in animals (14,29,36), the results reported in humans are contradictory (19,28,34,35).…”

Section: Flow Measurementsmentioning

confidence: 99%

“…Whereas all investigators agree on the capability of CT to demonstrate renal ischemia in animals (14,29,36), the results reported in humans are contradictory (19,28,34,35). TREU-GUT et coll.…”

Section: Flow Measurementsmentioning

confidence: 99%

“…(35) claimed that demonstration of renal ischemia due to unilateral renal artery stenosis was disappointing. PROBST et coll, (28), in contrast, successfully used dynamic CT to evaluate the effect of endoluminal percutaneous angioplasty in patients with renal artery stenosis.…”

Section: Flow Measurementsmentioning

confidence: 99%

“…CT scanning has been used for quantitation of flow through phantoms (13). The ability of cr to estimate cardiac output, cerebral, myocardial and renal blood flow as well as relative blood flow in the liver have all been documented (2,10,15,20,(27)(28)(29)36). CT scanning has been used in addition to demonstrate cerebral (7), renal (37), and myocardial infarction (1).…”

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confidence: 99%

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Attenuation Changes of the Normal and Ischemic Canine Kidney

Jaschke¹,

Lipton²,

Boyd³

et al. 1985

Acta Radiologica. Diagnosis

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The potential of CT scanning to explore total and regional renal blood flow was evaluated in a dog model with unilateral renal artery stenosis (n = 7, reduction of renal blood flow: 32-75% of base line flow). Attenuation versus time curves were generated for the renal cortex and medulla, as well as for the aorta and renal vein. A fast CT scanner was used which allowed for up to 24 scans/minute at the same level (slice thickness: 10 mm). A total of 10 ml contrast medium was injected into a peripheral vein for each scan series taken. During baseline conditions, the curve of the renal cortex and medulla demonstrated 2 peaks. The first peak was mainly related to early vascular enhancement, whereas the second peak corresponded mainly to the appearance of contrast medium in the distal convolutes and collecting ducts. Ischemia of the kidney resulted in a reduction of the first peak and a flattening of the leading edge slope. Transport of contrast medium through the extravascular compartments of the kidney was delayed during ischemia. Relative renal blood flow was obtained from the CT data by dividing peak enhancement by rise-time as assessed from the cortical curve. All measurements were related to baseline flow and validated by flow measurements using radioactive labeled microspheres (n = 5). Correlation was found to be r = 0.97.

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CT Perfusion in the Treatment of a Swine Model of Unilateral Renal Artery Stenosis: Validation with Microspheres

Paul

Lum

Consigny

et al. 2009

Journal of Vascular and Interventional Radiology

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Renal Artery Stenosis and Evaluation of the Effect of Endoluminal Dilatation: Comparison of Dynamic CT Scanning and I-131-OIHA Renogram

Cited by 9 publications

References 0 publications

Renography: Prediction of Blood Pressure after Dilatation of Renal Artery Stenosis

Renography: Prediction of Blood Pressure after Dilatation of Renal Artery Stenosis

Attenuation Changes of the Normal and Ischemic Canine Kidney

CT Perfusion in the Treatment of a Swine Model of Unilateral Renal Artery Stenosis: Validation with Microspheres

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