title: Utility of a 0.014" pressure-sensing guidewire to assess renal artery translesional systolic pressure gradients.
abstract: 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.
authors.affiliation: Department of Medicine, Division of Cardiology, Medical College of Ohio, Toledo, Ohio, USA. wcolyer@mco.edu
authors.forename: William R
authors.initials: WR
authors.lastname: Colyer
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Cooper
authors.forename: Mark W
authors.initials: MW
authors.lastname: Burket
authors.forename: William J
authors.initials: WJ
authors.lastname: Thomas
mesh_terms: 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