C M Gross1, J Krämer, O Weingärtner, F Uhlich, F C Luft, J Waigand, R Dietz. 1. Franz Volhard Clinic, Max Delbrück Center for Molecular Medicine, Charité, Humboldt University of Berlin, Wiltbergstrasse 50, 13125 Berlin, Germany. gross@fvk-berlin.de
Abstract
PURPOSE: To determine the hemodynamic significance of arteriographically detected renal arterial stenosis by obtaining pressure gradients with a miniaturized pressure guide wire. MATERIALS AND METHODS: Forty-six renal arterial stenoses in 38 patients were assessed in terms of severity and then subjected to gradient determination before and after angioplasty. The patients (mean age, 63 years) had a mean serum creatinine value of 1.3 mg/dL +/- 0.4 (114.9 micromol/L +/- 35.4 [SD]) and required on average three medications for blood pressure control. The mean degree of stenosis diameter was 51% +/- 17 (range, 12%-85%). RESULTS: The systolic and mean arterial pressure gradients with and those without vasodilatation were highly correlated with stenosis severity, systolic blood pressure, and serum creatinine as a curvilinear fit (r = 0.9, P <.01). At 50% stenosis severity, the mean pressure gradient was 22 mm Hg. CONCLUSION: Patients with a pressure gradient greater than 20 mm Hg should be good candidates for renal arterial dilatation, and use of the pressure guide wire will facilitate interventional decisions.
PURPOSE: To determine the hemodynamic significance of arteriographically detected renal arterial stenosis by obtaining pressure gradients with a miniaturized pressure guide wire. MATERIALS AND METHODS: Forty-six renal arterial stenoses in 38 patients were assessed in terms of severity and then subjected to gradient determination before and after angioplasty. The patients (mean age, 63 years) had a mean serum creatinine value of 1.3 mg/dL +/- 0.4 (114.9 micromol/L +/- 35.4 [SD]) and required on average three medications for blood pressure control. The mean degree of stenosis diameter was 51% +/- 17 (range, 12%-85%). RESULTS: The systolic and mean arterial pressure gradients with and those without vasodilatation were highly correlated with stenosis severity, systolic blood pressure, and serum creatinine as a curvilinear fit (r = 0.9, P <.01). At 50% stenosis severity, the mean pressure gradient was 22 mm Hg. CONCLUSION:Patients with a pressure gradient greater than 20 mm Hg should be good candidates for renal arterial dilatation, and use of the pressure guide wire will facilitate interventional decisions.
Authors: Thorsten A Bley; Kevin M Johnson; Christopher J François; Scott B Reeder; Mark L Schiebler; Benjamin R Landgraf; Daniel Consigny; Thomas M Grist; Oliver Wieben Journal: Radiology Date: 2011-08-03 Impact factor: 11.105
Authors: A S Turk; K M Johnson; D Lum; D Niemann; B Aagaard-Kienitz; D Consigny; J Grinde; P Turski; V Haughton; C Mistretta Journal: AJNR Am J Neuroradiol Date: 2007-01 Impact factor: 3.825
Authors: Jingfeng Jiang; Charles Strother; Kevin Johnson; Sara Baker; Dan Consigny; Oliver Wieben; James Zagzebski Journal: Phys Med Biol Date: 2011-02-23 Impact factor: 3.609
Authors: Edmund Kenneth Kerut; Stephen A Geraci; Chester Falterman; David Hunter; Curtis Hanawalt; Thomas D Giles Journal: J Clin Hypertens (Greenwich) Date: 2006-07 Impact factor: 3.738