Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension

Lucas Lauder, Sebastian Ewen, Abraham R. Tzafriri, Elazer R. Edelman, Thomas F. Lüscher, Peter J. Blankestijn, Oliver Dörr, Markus Schlaich, Faisal Sharif, Michiel Voskuil, Thomas Zeller, Christian Ukena, Bruno Scheller, Michael Böhm, Felix Mahfoud

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aims: With increasing attention to renovascular causes and targets for hypertension there arises a critical need for more detailed knowledge of renal arterial anatomy. However, a standardised nomenclature is lacking. The present study sought to develop a standardised nomenclature for renal anatomy considering the complexity and variation of the renal arterial tree and to assess the applicability of the nomenclature. Methods and results: One thousand hypertensive patients underwent invasive selective renal artery angiography in nine centres. Further, renovasography was performed in 249 healthy swine as a surrogate for normotensive anatomy. Anatomical parameters were assessed by quantitative vascular analysis. Patients' mean blood pressure was 168/90±26/17 mmHg. The right main renal artery was longer than the left (41±15 mm vs. 35±13 mm, p<0.001), but the left had a greater diameter (5.4±1.2 vs. 5.2±1.2 mm, p<0.001). Accessory renal arteries and renal artery disease were documented in 22% and 9% of the patients, respectively. Other than exhibiting a longer left main renal artery in uncontrolled hypertensives (+2.7 mm, p=0.034) there was no anatomical difference between patients with controlled and uncontrolled hypertension. Main renal artery mean diameter was smaller in patients with impaired kidney function (GFR <90 ml/min, left -0.5 mm, right -0.4 mm, both p<0.001). Conclusions: Renal arterial anatomy differs between sides but shows no difference between patients with and without blood pressure control. Impaired GFR was associated with small main renal artery diameter.

Original languageEnglish
Pages (from-to)121-128
Number of pages8
JournalEuroIntervention
Volume14
Issue number1
DOIs
Publication statusPublished - 1 May 2018

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