Short Term Prognosis of Renal Artery Stenosis Secondary to Acute Type B Aortic Dissection With TEVAR

Lei Li; Maozhou Wang; Jinzhang Li; Xinliang Guan; Pu Xin; Xiaolong Wang; Yuyong Liu; Haiyang Li; Wenjian Jiang; Ming Gong; Hongjia Zhang

doi:10.3389/fcvm.2021.658952

Short Term Prognosis of Renal Artery Stenosis Secondary to Acute Type B Aortic Dissection With TEVAR

Front Cardiovasc Med. 2021 Apr 23:8:658952. doi: 10.3389/fcvm.2021.658952. eCollection 2021.

Authors

Lei Li^{1

2

3}, Maozhou Wang^{1

2

3}, Jinzhang Li^{1

2

3}, Xinliang Guan^{1

2

3}, Pu Xin^{2

3

4}, Xiaolong Wang^{1

2

3}, Yuyong Liu^{1

2

3}, Haiyang Li^{1

2

3}, Wenjian Jiang^{1

2

3}, Ming Gong^{1

2

3}, Hongjia Zhang^{1

2

3}

Affiliations

¹ Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
² Beijing Aortic Disease Center, Cardiovascular Surgery Center, Beijing, China.
³ Beijing Lab for Cardiovascular Precision Medicine, Beijing, China.
⁴ Department of Medical Imaging, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Abstract

Objective: To determine the effect of renal artery stenosis (RAS) resulting from acute type B aortic dissection (ATBAD) with thoracic endovascular aortic repair (TEVAR) on early prognosis in patients with ATBAD. Methods: A total of 129 ATBAD patients in the National Acute Aortic Syndrome Database (AASCN) who underwent TEVAR between 2019 and 2020 were enrolled in our study. Patients were divided into two groups: the RAS group and the non-RAS group. Results: There were 21 RAS patients (16.3%) and 108 non-RAS patients (83.7%) in our cohort. No patient in our cohort died during the 1-month follow-up. There was no significant difference in preoperative creatinine clearance rate (CCr) between the two groups (90.6 ± 46.1 μmol/L in the RAS group vs. 78.7 ± 39.2 μmol/L in the non-RAS group, P = 0.303) but the RAS group had a significantly lower estimated glomerular filtration rate (eGFR) than the non-RAS group (83.3 ± 25.0 vs. 101.9 ± 26.9 ml/min, respectively; P = 0.028).One month after TEVAR, CCr was significantly higher (99.0 ± 68.1 vs. 78.5 ± 25.8 ml/min, P = 0.043) and eGFR (81.7 ± 23.8 vs. 96.0 ± 20.0 ml/min, P = 0.017) was significantly lower in the RAS group than in the non-RAS group. Conclusions: In ATBAD, RAS could result in acute kidney injury (AKI) in the early stage after TEVAR. The RAS group had a high incidence of hypertension. These results suggest that patients with RAS may need further treatment.

Keywords: acute kidney injury; acute type B aortic dissection; early prognosis; hypertension; renal artery stenosis.