TY - JOUR
T1 - Renal artery anatomy assessed by quantitative analysis of selective renal angiography in 1,000 patients with hypertension
AU - Lauder, Lucas
AU - Ewen, Sebastian
AU - Tzafriri, Abraham R.
AU - Edelman, Elazer R.
AU - Lüscher, Thomas F.
AU - Blankestijn, Peter J.
AU - Dörr, Oliver
AU - Schlaich, Markus
AU - Sharif, Faisal
AU - Voskuil, Michiel
AU - Zeller, Thomas
AU - Ukena, Christian
AU - Scheller, Bruno
AU - Böhm, Michael
AU - Mahfoud, Felix
PY - 2018/5/1
Y1 - 2018/5/1
N2 - 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.
AB - 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.
KW - Clinical research
KW - Device-based blood pressure therapy
KW - Hypertension
KW - Renal anatomy
UR - http://www.scopus.com/inward/record.url?scp=85049002580&partnerID=8YFLogxK
U2 - 10.4244/EIJ-D-18-00112
DO - 10.4244/EIJ-D-18-00112
M3 - Article
C2 - 29633939
AN - SCOPUS:85049002580
VL - 14
SP - 121
EP - 128
JO - EUROINTERVENTION : JOURNAL OF EUROPCR IN COLLABORATION WITH THE WORKING GROUP ON INTERVENTIONAL CARDIOLOGY OF THE EUROPEAN SOCIETY OF CARDIOLOGY
JF - EUROINTERVENTION : JOURNAL OF EUROPCR IN COLLABORATION WITH THE WORKING GROUP ON INTERVENTIONAL CARDIOLOGY OF THE EUROPEAN SOCIETY OF CARDIOLOGY
SN - 1774-024X
IS - 1
ER -