Impact of Renal Artery Stent-Graft Placement on Renal Function in Chronic Aortic Dissection

Tzu Ting Kuo, Chun Yang Huang, Po Lin Chen, I. Ming Chen, Chun Che Shih

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the effect of renal stent-graft placement on kidney function and size alternation in chronic aortic dissection. Materials and Methods: Twenty-five consecutive patients with chronic aortic dissection after thoracic endovascular aortic repair who underwent renal stent-graft placement between January 2015 and December 2016 were retrospectively reviewed. Forty-three patients with chronic aortic dissection who received thoracic endovascular aortic repair in the same period were reviewed as a control group for kidney volume comparison. Results: Twenty-five stent-grafts were deployed over 25 renal arteries. Overall renal function was assessed by the slope of the regression line constructed from the plots of creatinine clearance versus time within 2 years after the procedure (–0.2810 vs –0.3146 mL/min–1/mo–1, P =.868), kidney volume at 12 months (129.4 ± 40.9 vs 137.0 ± 44.2 cm2, P =.193) and effective renal plasma flow at 6 months (106.3 ± 46.9 vs 124.4 ± 55.5 mL/min, P =.050) and was not significantly deteriorated. Seven treated patients (87.5%) with a renal artery supplied by a false lumen had a decrease in kidney volume, as did 14 patients (56%) in the control group (P =.206). Three patients with a dissected renal artery (75%) in the stent-graft group had an increase in kidney volume compared with 1 patient (11.1%) in the control group (P =.052). Conclusions: Occlusion of the re-entry tear by a stent-graft in the renal artery remains a safe strategy to promote false lumen thrombosis. The stent-graft poses a potential risk of reducing the kidney volume in kidneys supplied by the false lumen but may provide a positive effect in kidney volume with a concomitant dissected renal artery in chronic aortic dissection.

Original languageEnglish
Pages (from-to)979-986
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume30
Issue number7
DOIs
Publication statusPublished - Jul 1 2019
Externally publishedYes

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Renal Artery
Stents
Dissection
Transplants
Kidney
Control Groups
Thorax
Effective Renal Plasma Flow
Tears
Creatinine
Thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Impact of Renal Artery Stent-Graft Placement on Renal Function in Chronic Aortic Dissection. / Kuo, Tzu Ting; Huang, Chun Yang; Chen, Po Lin; Chen, I. Ming; Shih, Chun Che.

In: Journal of Vascular and Interventional Radiology, Vol. 30, No. 7, 01.07.2019, p. 979-986.

Research output: Contribution to journalArticle

Kuo, Tzu Ting ; Huang, Chun Yang ; Chen, Po Lin ; Chen, I. Ming ; Shih, Chun Che. / Impact of Renal Artery Stent-Graft Placement on Renal Function in Chronic Aortic Dissection. In: Journal of Vascular and Interventional Radiology. 2019 ; Vol. 30, No. 7. pp. 979-986.
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abstract = "Purpose: To evaluate the effect of renal stent-graft placement on kidney function and size alternation in chronic aortic dissection. Materials and Methods: Twenty-five consecutive patients with chronic aortic dissection after thoracic endovascular aortic repair who underwent renal stent-graft placement between January 2015 and December 2016 were retrospectively reviewed. Forty-three patients with chronic aortic dissection who received thoracic endovascular aortic repair in the same period were reviewed as a control group for kidney volume comparison. Results: Twenty-five stent-grafts were deployed over 25 renal arteries. Overall renal function was assessed by the slope of the regression line constructed from the plots of creatinine clearance versus time within 2 years after the procedure (–0.2810 vs –0.3146 mL/min–1/mo–1, P =.868), kidney volume at 12 months (129.4 ± 40.9 vs 137.0 ± 44.2 cm2, P =.193) and effective renal plasma flow at 6 months (106.3 ± 46.9 vs 124.4 ± 55.5 mL/min, P =.050) and was not significantly deteriorated. Seven treated patients (87.5{\%}) with a renal artery supplied by a false lumen had a decrease in kidney volume, as did 14 patients (56{\%}) in the control group (P =.206). Three patients with a dissected renal artery (75{\%}) in the stent-graft group had an increase in kidney volume compared with 1 patient (11.1{\%}) in the control group (P =.052). Conclusions: Occlusion of the re-entry tear by a stent-graft in the renal artery remains a safe strategy to promote false lumen thrombosis. The stent-graft poses a potential risk of reducing the kidney volume in kidneys supplied by the false lumen but may provide a positive effect in kidney volume with a concomitant dissected renal artery in chronic aortic dissection.",
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T1 - Impact of Renal Artery Stent-Graft Placement on Renal Function in Chronic Aortic Dissection

AU - Kuo, Tzu Ting

AU - Huang, Chun Yang

AU - Chen, Po Lin

AU - Chen, I. Ming

AU - Shih, Chun Che

N1 - Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Purpose: To evaluate the effect of renal stent-graft placement on kidney function and size alternation in chronic aortic dissection. Materials and Methods: Twenty-five consecutive patients with chronic aortic dissection after thoracic endovascular aortic repair who underwent renal stent-graft placement between January 2015 and December 2016 were retrospectively reviewed. Forty-three patients with chronic aortic dissection who received thoracic endovascular aortic repair in the same period were reviewed as a control group for kidney volume comparison. Results: Twenty-five stent-grafts were deployed over 25 renal arteries. Overall renal function was assessed by the slope of the regression line constructed from the plots of creatinine clearance versus time within 2 years after the procedure (–0.2810 vs –0.3146 mL/min–1/mo–1, P =.868), kidney volume at 12 months (129.4 ± 40.9 vs 137.0 ± 44.2 cm2, P =.193) and effective renal plasma flow at 6 months (106.3 ± 46.9 vs 124.4 ± 55.5 mL/min, P =.050) and was not significantly deteriorated. Seven treated patients (87.5%) with a renal artery supplied by a false lumen had a decrease in kidney volume, as did 14 patients (56%) in the control group (P =.206). Three patients with a dissected renal artery (75%) in the stent-graft group had an increase in kidney volume compared with 1 patient (11.1%) in the control group (P =.052). Conclusions: Occlusion of the re-entry tear by a stent-graft in the renal artery remains a safe strategy to promote false lumen thrombosis. The stent-graft poses a potential risk of reducing the kidney volume in kidneys supplied by the false lumen but may provide a positive effect in kidney volume with a concomitant dissected renal artery in chronic aortic dissection.

AB - Purpose: To evaluate the effect of renal stent-graft placement on kidney function and size alternation in chronic aortic dissection. Materials and Methods: Twenty-five consecutive patients with chronic aortic dissection after thoracic endovascular aortic repair who underwent renal stent-graft placement between January 2015 and December 2016 were retrospectively reviewed. Forty-three patients with chronic aortic dissection who received thoracic endovascular aortic repair in the same period were reviewed as a control group for kidney volume comparison. Results: Twenty-five stent-grafts were deployed over 25 renal arteries. Overall renal function was assessed by the slope of the regression line constructed from the plots of creatinine clearance versus time within 2 years after the procedure (–0.2810 vs –0.3146 mL/min–1/mo–1, P =.868), kidney volume at 12 months (129.4 ± 40.9 vs 137.0 ± 44.2 cm2, P =.193) and effective renal plasma flow at 6 months (106.3 ± 46.9 vs 124.4 ± 55.5 mL/min, P =.050) and was not significantly deteriorated. Seven treated patients (87.5%) with a renal artery supplied by a false lumen had a decrease in kidney volume, as did 14 patients (56%) in the control group (P =.206). Three patients with a dissected renal artery (75%) in the stent-graft group had an increase in kidney volume compared with 1 patient (11.1%) in the control group (P =.052). Conclusions: Occlusion of the re-entry tear by a stent-graft in the renal artery remains a safe strategy to promote false lumen thrombosis. The stent-graft poses a potential risk of reducing the kidney volume in kidneys supplied by the false lumen but may provide a positive effect in kidney volume with a concomitant dissected renal artery in chronic aortic dissection.

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