Document Detail

Effects of balloon angioplasty and stent implantation on intrarenal echo-Doppler velocimetric indices.
MedLine Citation:
PMID:  9607215     Owner:  NLM     Status:  MEDLINE    
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.
I Marana; F Airoldi; L Burdick; C Alberti; A Lovaria; S Saccheri; G Gazzano; S Palatresi; B Nador; L Turolo; A Morganti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international     Volume:  53     ISSN:  0085-2538     ISO Abbreviation:  Kidney Int.     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-08-03     Completed Date:  1998-08-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1795-800     Citation Subset:  IM    
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Italy.
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MeSH Terms
Aged, 80 and over
Angioplasty, Balloon*
Angiotensin II / blood
Blood Pressure / physiology
Hypertension / complications
Laser-Doppler Flowmetry*
Middle Aged
Regression Analysis
Renal Artery Obstruction / complications,  physiopathology,  therapy*
Renal Circulation / physiology*
Renin / blood
Reg. No./Substance:
11128-99-7/Angiotensin II; EC

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