Natural history of atherosclerotic renal artery stenosis associated with aortic disease
Open accessAbstract
The natural history of atherosclerotic renal artery stenosis has not been well defined, particularly when discovered in conjunction with aortic disease requiring correction. To better define the natural history of such lesions, 194 sequential aortograms in 48 patients were studied to define predictive criteria for stenoses at risk for progression. Sixty-six unsuspected atherosclerotic renal arterial stenoses were identified on the initial aortograms. Disease progressed in 42 arteries (53%), 14 bilateral and 28 unilateral. Seven arteries developed occlusion. All had stenoses averaging 80% (range 61% to 94%) noted on the most recent aortogram preceding occlusion. Risk factors including smoking, diabetes mellitus, elevated serum lipids, coronary artery disease, peripheral arterial disease, or change in blood pressure or creatinine, did not correlate with degree or rate of progression of the renal artery stenosis. A difference in kidney size, although varying inversely with degree of stenosis, was not a statistically significant marker of disease progression. This analysis suggests that identification of renal arterial stenoses that will progress is best determined by sequential aortography. Highly stenotic vessels are more prone to occlude than those less stenotic. Consequently, individuals with preocclusive lesions should benefit from prophylactic renal revascularization during aortic reconstruction.
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Atherosclerotic disease often coexists in patients with AAA.
“[Statement]Atherosclerotic disease often coexists in patients with AAA. (Evidence level: E-2)”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [200]
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- Authors
- Tollefson, D. F. J., & Ernst, C. B.
- Affiliations
- Henry Ford Hospital (US)
- Venue
- Journal of Vascular Surgery
- Publisher
- Elsevier BV
- Published
- 1991-09
- Volume
- 14
- Issue
- 3
- Pages
- 327-331
- ISSN
- 0741-5214 (ISSN-L)
- OpenAlex
- W2069714065
- Cited by
- 235
- References
- 24
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 1 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 8 · 2013: 4 · 2012: 8
- FWCI
- 7.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Vascular Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal and Vascular Pathologies
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- atherosclerotic renal artery stenosis, natural history (disease), aortic disease, aortography, stenosis progression, renal artery occlusion, risk factors, kidney size, aortic reconstruction, smoking, diabetes mellitus, serum lipids
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aortic Diseases, Aortography, Arteriosclerosis, Blood Pressure, Follow-Up Studies, Humans, Hypertension, Male, Middle Aged, Regression Analysis, Renal Artery, Renal Artery Obstruction, Risk Factors, Smoking
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