Value of fractional flow reserve measurement in endovascular therapy for patients with Stanford B type aortic dissection complicated with renal blood flow injury
10.3760/cma.j.issn.0253-3758.2015.10.004
- VernacularTitle:血流储备分数在Stanford B型主动脉夹层累及肾动脉患者介入治疗中的应用
- Author:
Xi GUO
1
;
Peng LI
;
Guangrui LIU
;
Xiaoyong HUANG
;
Qiang YONG
;
Guoqin WANG
;
Lianjun HUANG
Author Information
1. 100029,首都医科大学附属北京安贞医院介入诊疗科
- Keywords:
Fractional flow reserve,myocardial;
Aortic diseases;
Renal circulation
- From:
Chinese Journal of Cardiology
2015;43(10):854-857
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the value of fractional flow reserve (FFR) measurement on endovascular therapy for patients with renal artery stenosis.Methods Clinical data of 12 patients with Stanford B type aortic dissection complicated with renal blood flow injury in Anzhen hospital hospitalized from May 2013 to February 2014 were retrospectively analyzed.Renal artery angiography was performed and fractional flow reserve (FFR) was measured before Thoracic endovascular aortic repair.After operation, renal artery FFR was measured again, and renal artery stenting was performed in patients with FFR≤0.90 or average pressure difference between proximal and distal of renal artery ＞ 20 mmHg(1 mmHg =0.133 kPa) and not applied for patients with FFR ＞ 0.90.The patients were then subsequently followed up clinically.Kidney function were measured after 1 month, and contrast-enhanced ultrasonography data were obtained at 1 and 3 months later, respectively.Results The FFR of 1 patient was 0.90, while the FFR of other patients were less than 0.90 before thoracic endovascular aortic repair.After the procedure, the angiography showed that the blood flow of renal artery in 8 patients were fluency, and the FFR index was over 0.90.There were 4 patients with FFR less than 0.90.After renal artery stenting, the FFR of these 4 patients were all above 0.90.Compared with pre-procedure, blood urea nitrogen ((8.84 ± 3.99) mmol/L vs.(5.18 ± 1.69) mmol/L, P =0.011) and uric acid ((359.3 ± 77.3) μmol/L vs.(276.9 ± 108.3) μmol/L, P =0.008) decreased significantly after 1 month, and there was no significant difference in serum creatinine (P =0.760).Contrast-enhanced ultrasonography results showed that blood flow of renal artery were fluency after 1 month and 3 months.Conclusion In patients with aortic dissection complicating renal blood flow injury, the FFR measurement is meaningful in evaluating the blood flow status of target organs and guide the endovascular revascularization
