Utility of a 0.014" pressure-sensing guidewire to assess renal artery translesional systolic pressure gradients.
Renal ischemia due to renal artery stenosis (RAS) is an important cause of secondary hypertension and renal insufficiency. Several methods are available to diagnose RAS; however, the identification of clinically significant lesions remains problematic. We measured the translesional systolic pressure gradient (TSPG) with a 4 Fr catheter and a 0.014" pressure-sensing guidewire and compared these data to angiographic findings. The TSPG obtained by pressure-sensing guidewire correlated more strongly with angiographic minimal lumen diameter (r(2) = 0.801) than those obtained by 4 Fr catheter (r(2) = 0.360). The relationship of TSPG with percent stenosis was not strong, regardless of the method used (r(2) = 0.228 with pressure-sensing guidewire, 0.358 with 4 Fr catheter). Using a 0.014" pressure-sensing guidewire is effective for assessing TSPG and provides a more reliable indication of stenosis significance than use of a 4 Fr catheter.
Colyer
William R
WR
Department of Medicine, Division of Cardiology, Medical College of Ohio, Toledo, Ohio, USA. wcolyer@mco.edu
Cooper
Christopher J
CJ
Burket
Mark W
MW
Thomas
William J
WJ
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001795:Blood Pressure Determination; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D015331:Cohort Studies; D004869:Equipment Safety; D005260:Female; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D011336:Probability; D011446:Prospective Studies; D012044:Regression Analysis; D012078:Renal Artery Obstruction / Q000175:diagnosis*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index