Aortic Dissection Clinical Trial
Official title:
On-table Renal Perfusion Evaluation for Patients With Renal Artery Stenosis or Aortic Dissection With Renal Artery Obstruction
1. Evaluate the feasibility for the on-table evaluation of the renal perfusion by using
Syngo Dyna Parenchymal Blood Volume(PBV) Body;
2. Explore the clinical benefits of this application during procedure to help the physician
to determine the procedure endpoint.
Renal artery stenosis (RAS) is one of the potential manifestations of peripheral artery
diseases and it is often observed in patients with evolving renal function impairment and
concomitant coronary artery disease, or in those suffering from hypertension refractory to
medical therapy.Percutaneous renal artery stenting is an effective therapeutic tool and
represents the treatment of choice for RAS. Identification of parameters able to discriminate
patients who benefit from RAS stenting, thus, has become of crucial importance if this
technique has to survive.
Aortic dissection represents a common cardiovascular disease and it is responsible for the
most commonly encountered pathologies in aortic emergency. Renal dysfunction is a common
complication associated with aortic dissection, with resultant high mortality rate. The
antegrade propagation of the dissection from the proximal aorta to the level of renal
arteries and the intervention during surgery may both increase the risk of renal
malperfusion; thus, it is important to assess renal function for pre- and post-operative
evaluation and guidance for treatment. This can be achieved through perfusion imaging.
Presently, C-arm Cone Beam Computed Tomography (CBCT) perfusion is well established, in
particular, in the diagnostic assessment of acute stroke and cerebral ischemia. The main
novelty of our study lies in the fact that intra-procedural renal perfusion assessed for the
first time semiquantitatively by Syngo Dyna Parenchymal Blood Volume(PBV) software,
discriminate patients who will benefit from the intervention procedure.
In conclusion, our study suggests that a routine assessment of pre, and post-stenting renal
perfusion could help to identify patients at higher risk of no improvement or even worsening
of renal function after stenting and, perhaps, more aggressive medical therapy.
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