The Association Between IVUS Characteristics Of Renal Artery Stenosis And Short-term Prognosis After Percuta-Neous Renal Artery Intervention

Objectives:To explore the effect of the lesion characteristics on short-term prognosisafter renal artery intervention (RAI)．Methods:Renal angiography and intravascular ultrasonography (IVUS) and/or withvirtual histology (VH-IVUS)–derived plaque characteristics were assessedfor25patients with atherosclerotic renal artery stenosis (enrolled betweenJanuary1,2008, to November30,2013). After RAI, serum creatinine andblood pressure was followed-up at1week,3months,6months, at the sametime,estimated glomerular filtration rate (eGFR) was evaluated at baselineand at1week,3months and6months．Results:In this study included25patients(21male,4female). In gray scale IVUSanalysis, cross-sectional area（CSA）of the plaque was significantly negativecorrelated with baseline eGFR (r=-0.448; P=.0025). Plaque componentsclassified by VH-IVUS had no correlation with baseline eGFR. During3months and6months follow-up of22patients, the improvement of eGFRafter RAI was observed in15patients, and deteriorated in7patients. After1week,3month and6month, the percent change in eGFR after RAI weresignificantly correlated with the minimum CSA of the lumen measured byIVUS (r=0.632, p=0.001r=0.586, p=0.004r=0.496, p=0.019).Thepercent change in eGFR1week after RAI was negatively correlated with themean percentage of dense calcium and necrotic core analyzed by VH-IVUS(r=-0.634, p=0.011r=-0.566, p=0.028), But3,6months after RAI,the percent change in eGFR had no correlation with plaque components classifiedby VH-IVUS. After RAI, followed up for1week,3month and6month，theaverage systolic blood pressure were significant drop of7.3%,10.7%and13.9%respectively, the IVUS data had no correlation with postoperativeblood pressure changes.Conclusion:In patients with atherosclerotic renal artery stenosis, the percent change ineGFR after RAI were significantly correlated with the minimum CSA of thelumen measured by IVUS. The evaluation of lesions by IVUS may providemore insights into the change in renal function and blood pressure after RAI.