The effect of revascularization of renal artery stenosis on renal perfusion in patients with atherosclerotic renovascular disease.
BACKGROUND
Only a small fraction of patients with atherosclerotic renovascular disease (ARVD) treated with revascularization have improved renal function after the procedure. It has been suggested that this may be due to effects of renal microvascular disease. Our aim was to measure the effect of renal artery stenosis (RAS) revascularization on renal perfusion in patients with renovascular disease.


METHODS
Seventeen renovascular disease patients were treated by dilatation of unilateral (N = 8) or bilateral (N = 9) RAS (N = 23 kidneys), mainly because of uncontrolled or refractory hypertension. The patients were studied before and after (103 ± 29 days) the procedure. Renal perfusion was measured using quantitative positron emission tomography (PET) perfusion imaging.


RESULTS
Although renal perfusion correlated inversely with the degree of RAS in patients with renovascular disease, it did not change after revascularization.


CONCLUSIONS
Our data support the notion of former clinical trials that angiographic severity of RAS does not determine the response to revascularization. Quantitative PET perfusion imaging is a promising tool to noninvasively measure renal perfusion for the assessment of physiological impact of RAS.
Department of Medicine, Turku University Hospital, Turku, Finland. niina.koivuviita@tyks.fi
Niina
N
Koivuviita
Kaisa
K
Liukko
Nobu
N
Kudomi
Vesa
V
Oikonen
Risto
R
Tertti
Ilkka
I
Manner
Tero
T
Vahlberg
Pirjo
P
Nuutila
Kaj
K
Metsärinne
D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000379:methods*; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012079:Renal Circulation