Talenfeld Adam D, Schwope Ryan B, Alper Huntley J, Cohen Emil I, Lookstein Robert A
Division of Interventional Radiology, Mount Sinai Medical Center, One Gustave L. Levy Pl., Box 1234, New York, NY 10029, USA.
AJR Am J Roentgenol. 2007 Jun;188(6):1652-8. doi: 10.2214/AJR.06.1255.
Use of distal protection in renal artery stenting entails overcoming challenges unique to renal artery anatomy. We used 3D image reconstruction to review high-spatial-resolution MDCT angiographic data to better characterize the anatomy of stenotic renal arteries.
A total of 218 abdominal MDCT angiograms from a single tertiary care referral center were reviewed. The subjects were 108 patients who had 127 arteries with more than 50% ostial atherosclerotic renal artery stenosis. Vessel analysis software was used to measure renal artery length, cross-sectional area, and maximum diameter. Differences between mean values for women and men and for left and right renal arteries were measured with a two-tailed Student's t test.
Significant differences for men and women were found in average maximum cross-sectional area distal to the point of stenosis (0.3 +/- 0.19 vs 0.23 +/- 0.09 cm2, p = 0.006) and the corresponding maximum diameter (6.9 +/- 1.7 vs 6.1 +/- 1.1 cm2, p = 0.003). Average lengths of the main renal artery did not differ significantly for men and women. Differences for the left and right main renal arteries were found in minimum area (i.e., area of maximum stenosis, 0.08 +/- 0.04 vs 0.06 +/- 0.03 cm2, p = 0.03), area proximal to the bifurcation (0.26 +/- 0.11 cm2 vs 0.23 +/- 0.07 cm2, p = 0.02), and length (38.5 +/- 12.6 vs 48.7 +/- 16.2 mm, p = 0.0002).
Significant anatomic differences exist between the left and right renal arteries, between the renal arteries in men and those in women, and from one person to the next. Many of these differences are relevant to the design and use of distal protection devices in stenting of the renal arteries.
在肾动脉支架置入术中使用远端保护装置需要克服肾动脉解剖结构所特有的挑战。我们使用三维图像重建技术来回顾高空间分辨率的MDCT血管造影数据，以更好地描述狭窄肾动脉的解剖结构。
回顾了来自单一三级医疗转诊中心的218例腹部MDCT血管造影。研究对象为108例患者，其127条动脉存在超过50%的开口处动脉粥样硬化性肾动脉狭窄。使用血管分析软件测量肾动脉长度、横截面积和最大直径。采用双尾Student t检验测量女性与男性以及左、右肾动脉平均值之间的差异。
在狭窄点远端的平均最大横截面积（0.3±0.19 vs 0.23±0.09 cm²，p = 0.006）和相应的最大直径（6.9±1.7 vs 6.1±1.1 cm²，p = 0.003）方面，男性和女性存在显著差异。男性和女性的肾动脉主干平均长度无显著差异。左、右肾动脉主干在最小面积（即最大狭窄面积，0.08±0.04 vs 0.06±0.03 cm²，p = 0.03）、分叉近端面积（0.26±0.11 cm² vs 0.23±0.07 cm²，p = 0.02）和长度（38.5±12.6 vs 48.7±16.2 mm，p = 0.0002）方面存在差异。
左、右肾动脉之间、男性与女性的肾动脉之间以及个体之间存在显著的解剖差异。其中许多差异与肾动脉支架置入术中远端保护装置的设计和使用有关。
