Acta clinica Croatica, Vol. 58. No. 2., 2019.
Original scientific paper
https://doi.org/10.20471/acc.2019.58.02.03
Ostial versus Truncal Renal Artery Stenosis: Predictor of Large Artery Atherosclerosis Severity and Higher Mortality
Dražen Perkov
orcid.org/0000-0001-5398-059X
; Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Vedran Premužić
; Department of Nephrology, Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Ranko Smiljanić
; Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Ljiljana Fodor
; Department of Nephrology and Dialysis, Sestre milosrdnice University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Savko Dobrota
; Department of Diagnostic and Interventional Radiology, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Bojan Jelaković
; Department of Nephrology, Hypertension, Dialysis and Transplantation, Zagreb University Hospital Centre, University of Zagreb School of Medicine, Zagreb, Croatia
Abstract
The aim of this study was to determine arterial stiffness and the effect of stenting in patients with renal artery stenosis. We hypothesized that ostial renal artery stenosis is not only a marker of more pronounced atherosclerosis of large arteries, but is also a predictor of higher cardiovascular mortality. We enrolled 33 patients with renal artery stenosis refractory to pharmacological treatment and divided them according to the renal artery stenosis location, ostial and truncal (23 vs.
10 patients). We analyzed patient survival at five-year follow up. After the intervention and at sixmonth follow up, there was a significant decrease in blood pressure values, as well as in pulse wave velocity (PWV) and augmentation index. PWV was significantly lower in patients with truncal renal artery stenosis and these patients were significantly younger. Twelve patients with ostial and one patient with truncal renal artery stenosis (52% vs. 10%, p<0.001) died from cardiovascular events. Our study is the first to confirm the predictive role of PWV and arterial stiffness in patients with renal artery stenosis, especially ostial one, and to emphasize its ability of detecting future higher incidence of
cardiovascular events.
Keywords
Renal artery obstruction; Atherosclerosis; Pulse wave analysis; Vascular stiffness; Mortality; Survival
Hrčak ID:
224349
URI
Publication date:
1.6.2019.
Visits: 1.413 *