Renal Artery Stenosis in Patients with Peripheral Artery Disease: Prevalence, Risk Factors and Long-term Prognosis
| العنوان: | Renal Artery Stenosis in Patients with Peripheral Artery Disease: Prevalence, Risk Factors and Long-term Prognosis |
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| المؤلفون: | Philippe Lacroix, Dania Mohty, Julien Magne, Victor Aboyans, G. Morange, Ileana Desormais |
| المساهمون: | Cardio-vascular diseases, Clinical sciences, Service de cardiologie [CHU Limoges], CHU Limoges, Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges] |
| المصدر: | European Journal of Vascular and Endovascular Surgery European Journal of Vascular and Endovascular Surgery, Elsevier, 2017, 53 (3), pp.380-385. ⟨10.1016/j.ejvs.2016.10.029⟩ |
| بيانات النشر: | W.B. Saunders Ltd, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, Time Factors, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Renal artery stenosis, surgery, 0302 clinical medicine, Risk Factors, Odds Ratio, Prevalence, 030212 general & internal medicine, Myocardial infarction, Stroke, Aged, 80 and over, Incidental Findings, medicine.diagnostic_test, Middle Aged, Limb Salvage, Prognosis, 3. Good health, Lower Extremity, Cardiology, outcome, Female, France, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Renal Artery Obstruction, Amputation, Surgical, 03 medical and health sciences, Peripheral Arterial Disease, medicine.artery, Internal medicine, medicine, Humans, Renal artery, Aged, Retrospective Studies, business.industry, Angiography, Digital Subtraction, Digital subtraction angiography, Odds ratio, medicine.disease, Confidence interval, Surgery, Stenosis, Logistic Models, Multivariate Analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business |
| الوصف: | International audience; OBJECTIVE/BACKGROUND:The objective was to determine the prevalence and clinical determinants of renal artery stenosis (RAS) in patients undergoing digital subtraction angiography (DSA) for the assessment of peripheral artery disease (PAD), and to evaluate its prognostic significance.METHODS:All DSAs performed from January 2000 to January 2006 were retrospectively reviewed for assessment of PAD in patients naive for any prior revascularisation of lower-limb arteries. All DSA studies were read by two senior physicians blinded to outcome, and consensus was reached in cases of disagreement. RAS was defined as the presence of ≥50% stenosis in either renal artery. Patients' electronic medical files were systematically reviewed and follow-up was completed by contact with family physicians until January 2014. The primary outcome was composite, including death, peripheral revascularisation, or any limb amputation. Secondary outcomes were all-cause mortality, and another composite, including death and non-fatal myocardial infarction or stroke or coronary or carotid revascularisation.RESULTS:In total, 400 consecutive patients having a first DSA of lower extremities, two thirds of whom were for critical limb ischaemia, were studied. Thirteen patients were excluded owing to poor renal artery imaging. RAS was detected in 57 patients (14%). Only two factors were independently and significantly associated with RAS in multivariate analysis: diffuse PAD (involving both proximal and distal segments [odds ratio {OR} 3.50, 95% confidence interval {CI} 1.16-10.54; p = .026]) and decreased glomerular filtration rate (OR 0.55 per 30 mL/minute/1.73 m2, 95% CI 0.41-0.75; p < .001). During follow-up (mean ± SD 62 ± 47 months), 25% experienced limb amputation and 54% died. In multivariate analysis, no significant association was found between RAS and primary outcome (hazard ratio 0.80; 95% CI 0.57-1.10). No significant association was found with secondary outcomes.CONCLUSION:Incidental RAS is frequent (14%) among patients with PAD undergoing lower extremity imaging. No difference in outcome in patients with RAS versus those without RAS was seen. Larger studies are necessary to draw definite conclusions. |
| اللغة: | English |
| تدمد: | 1078-5884 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f11373adcbaa0d6c9e0eff9682f81cabTest https://hdl.handle.net/20.500.14017/15df79ff-0319-4823-bd69-a5963f30ac5aTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f11373adcbaa0d6c9e0eff9682f81cab |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10785884 |
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