Value of Doppler parameters in the diagnosis of renal artery stenosis

Miralles, Manuel; Cairols, Marc; Cotillas, J.; Giménez, Antonio; Santiso, A.

doi:10.1016/s0741-5214(96)80007-3

Cited by 75 publications

(56 citation statements)

References 18 publications

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“…In our study as well as in others (Table 4a), the duplex ultrasound data of supernumerary renal arteries were excluded from evaluation, thereby accepting a number of inadequate examinations since these vessels may be as large as the main renal arteries and therefore of hemodynamic significance. 9,[11][12][13][19][20][21][22][23] In order to overcome these limitations, others have suggested the technique of duplex ultrasound examination of the intrarenal vasculature. 8,10,[24][25][26][27][28][29][30] Analysis of the Doppler spectral waveform, with several criteria, ie mean resistive index, tardusparvus phenomena and acceleration time, has been proposed as an alternative to detect upstream stenosis.…”

Section: Discussionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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The aim of this study was to evaluate the accuracy of duplex ultrasound for the diagnosis of renovascular disease in a cohort of hypertensive patients. In 78 patients suspected of renovascular hypertension on clinical grounds duplex ultrasound examination of the renal arteries was performed. Renal angiography was used as the standard of reference. Duplex ultrasound was inconclusive in 11 kidneys (7%). None of the supernumerary renal arteries was detected with duplex ultrasound. The overall prevalence of significant renovascular disease (у50% stenosis) was 20%. Based on the combination of parameters at thresholds commonly applied in current literature: ie PSV max Ͼ180 cm/sec and RAR Ͼ3.5 the overall sensitivity of duplex ultrasound for detection of haemodynamically significant renovascular disease was 50.0% with a specificity of 91.3% (PPV: 87.9%; NPV:

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Section: Discussionmentioning

confidence: 99%

Renovascular disease in patients with hypertension: detection with duplex ultrasound

et al. 2002

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“…Hansen et al 10 According to the initial studies at Washington University, a renal-aorta index ≥ 3.5 indicates hemodynamically significant renal artery stenosis [13][14][15] . Mirales et al 11 proposed a value > 3.3 for this criterion, but with values of sensitivity and specificity similar to those of the Washington group 11 .…”

Section: Discussionmentioning

confidence: 96%

“…Previous gastrointestinal preparation, ability of the examiner, and time for performing the examination are factors that contribute to reducing the percentage of inconclusive examinations 11 . Our inconclusive cases (4.4%), compatible with the figures in the literature, relate to the previously cited factors.…”

Section: Discussionmentioning

confidence: 99%

O papel da ultra-sonografia vascular com Doppler colorido na avaliação da hipertensão reno-vascular: acurácia da técnica direta de avaliação das artérias renais

Engelhorn

Pullig

2004

Arq. Bras. Cardiol.

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477The early diagnosis of patients suspected of having renovascular hypertension is important because of the risk of progression to renal insufficiency due to the nephropathic ischemia caused by lesions limiting the renal artery flow.The diagnosis of arterial hypertension resulting from renal artery stenosis may be established with the following different complementary examinations: determination of selective renin in the renal vein; functional study with radioisotopes; excretory urography; determination of the peripheral renin stimulated with captopril; magnetic angioresonance; angiography; and, more recently, vascular color Doppler ultrasound.Arteriography is the most precise method for diagnosing renal artery stenosis, but it has some limitations, such as allergic reaction and the risk of nephrotoxicity due to the contrast medium, in addition to complications inherent to the procedure and its high cost. Another important factor is that arteriography is an anatomic study, and, therefore, does not provide hemodynamic information about the renal lesions.This study aimed at assessing the accuracy of vascular color Doppler ultrasound as compared with that of arteriography in identifying hemodynamically significant renal artery stenoses. MethodsWe carried out a prospective double-blind study at the Noninvasive Vascular Laboratory of the Hospital de Caridade of the Santa Casa de Misericórdia de Curitiba/PUCPR, to assess the accuracy of vascular color Doppler ultrasound in the diagnosis of stenotic or obstructive lesions in the renal arteries as compared with that of arteriography, which is considered the gold standard.One hundred and thirty-seven renal arteries from 69 adult patients (30 men and 39 women) suspected of having renovascular arterial hypertension, with no distinction of complexion or biotype, and a mean age of 54 years were studied. One of the patients had undergone nephrectomy prior to the study.The following patients with arterial hypertension of recent onset were included in the study: young individuals with no familial history of hypertension; individuals > 55 years with arterial hypertension of recent onset or abrupt lack of control; hypertensive individuals refractory to treatment; hypertensive individuals with an abdominal murmur; and individuals with predominantly diastolic arterial hypertension (> 120 mmHg). Patients with the following characteristics were excluded from the study: previous diagnosis of renal artery lesion; history of allergy to iodinated contrast me- ObjectiveTo assess the accuracy of vascular color Doppler ultrasound as compared with digital subtraction arteriography for identifying hemodynamically significant renal artery stenoses. MethodsOne hundred and thirty-seven renal arteries from 69 adult patients suspected of having renovascular arterial hypertension were prospectively studied with ultrasound. The results obtained were compared in a double-blind manner with those obtained on digital subtraction arteriography, and the following parameters were calculated according to ...

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“…For cases with RAR values 43-3.5, one should be suspicious for the presence of a hemodynamically significant stenosis, and further investigations should be recommended. 14,38,39 RAPSV and RAR are direct Doppler parameters of RAS. The threshold value of RAS that gives rise to hypertension or ischemic damage varies from patient to patient, nevertheless, a 50-60% stenosis in the arterial diameter is accepted to be hemodynamically significant.…”

Section: Discussionmentioning

confidence: 99%

Renal artery stenosis and abdominal aorta aneurysm in patients with pseudoexfoliation syndrome

Gönen

Gümüş

2013

Eye

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Purpose To evaluate the renal arteries and abdominal aorta in patients with pseudoexfoliation syndrome (PEX). Design Prospective, case-control study. Methods The study involved 49 patients with PEX and 42 control subjects. Abdominal aorta and renal arteries were examined by Doppler ultrasonography. In both renal arteries (proximal and distal portions) and abdominal aorta, the peak systolic velocity (PSV) was measured. Renal artery stenosis (RAS) was defined as the renal artery PSV 4150 cm/s or renal-to-aortic ratio (RAR) 43.0. Patients who had an abdominal aortic diameter 43 cm were recorded. Computed tomographic angiography was performed to confirm these findings in patients with RAS and/or abdominal aorta aneurysm. Results The mean PSV in the proximal renal artery was 88.3 cm/s in PEX group and 79.5 cm/s in control group (P ¼ 0.314); in distal renal artery was 91.7 cm/s in PEX group and 93.0 cm/s in control group (P ¼ 0.794); in abdominal aorta was 76.0 cm/s in PEX group and 65.2 cm/s in control group (P ¼ 0.046). RAS was observed in nine patients with PEX and in only one patient without PEX (P ¼ 0.017). Seven out of 10 patients with RAS (six patients in PEX group; one patient in control group) had hypertension. Abdominal aorta aneurysm was observed in four patients in PEX group but not in control group (P ¼ 0.061). Conclusions Our study has demonstrated that there is a significant association between PEX and RAS. The abdominal aorta aneurysm may be seen in patients with PEX.

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Value of Doppler parameters in the diagnosis of renal artery stenosis

Cited by 75 publications

References 18 publications

Renovascular disease in patients with hypertension: detection with duplex ultrasound

Renovascular disease in patients with hypertension: detection with duplex ultrasound

O papel da ultra-sonografia vascular com Doppler colorido na avaliação da hipertensão reno-vascular: acurácia da técnica direta de avaliação das artérias renais

Renal artery stenosis and abdominal aorta aneurysm in patients with pseudoexfoliation syndrome

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