Can intrarenal duplex waveform analysis predict successful renal artery revascularizaion

摘要: Abstract Purpose: No currently available noninvasive test can preoperatively predict a successful outcome to renal revascularization. Resistance measurements from the parenchyma obtained with duplex sonography reflect magnitude of intraparenchymal disease, and patients extensive intrarenal disease may respond less favorably To address this question, we reviewed our (primarily) operative experience in undergoing artery revascularization, compared blood pressure (BP) function response resistance kidney both before after Methods: During 56-month period, 31 consecutive revascularizations (25 surgical 6 percutaneous angioplasties) were performed 23 (21 atherosclerotic, 2 fibromuscular dysplasia). Duplex was each patient parenchymal diastolic/systolic (d/s) ratios calculated. BP intervention flow patterns Results: Mean peak systolic velocity significantly higher repair all (pre-repair: 19.5 ± 1.3, postrepair: 27.2 1.7; P = .003). preoperative d/s when failures ( .048). Similarly, among single repairs, mean approached significance successes vs. (success: 0.40 0.03, failure: 0.21 0.03; .054). A decrease serum creatinine greater than or equal 20% seen 8 18 (44%) ischemic nephropathy. These also had normal (mean 0.39 0.04), whereas 10 who failed improve lower 0.24 .041). Kidney length did not correlate ratio. Conclusion: Although do believe that sonographic measurement alone is an accurate means assessing main occlusive resistive indices seem thus provide important prognostic information for Our data suggest ratio below 0.3 correlates clinical failure relative responses. (J Vasc Surg 1998;28:471-81.)