Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 24;10(9):1002.
doi: 10.3390/bioengineering10091002.

Evaluating Short-Term and Long-Term Risks Associated with Renal Artery Stenosis Position and Severity: A Hemodynamic Study

Yawei Zhao  1 , Yike Shi  1 , Yusheng Jin  1 , Yifan Cao  1 , Hui Song  2   3 , Lingfeng Chen  1 , Fen Li  2   3 , Xiaona Li  1 , Weiyi Chen  1
Affiliations

Evaluating Short-Term and Long-Term Risks Associated with Renal Artery Stenosis Position and Severity: A Hemodynamic Study

Yawei Zhao et al. Bioengineering (Basel). .

Abstract

Background: Moderate renal artery stenosis (50-70%) may lead to uncontrolled hypertension and eventually cause irreversible damage to renal function. However, the clinical criteria for interventional treatment are still ambiguous in this condition. This study investigated the impact of the position and degree of renal artery stenosis on hemodynamics near the renal artery to assess the short-term and long-term risks associated with this disease. Methods: Calculation models with different degrees of stenosis (50%, 60%, and 70%) located at different positions in the right renal artery were established based on the computed tomography angiography (CTA) of a personalized case. And computational fluid dynamics (CFD) was used to analyze hemodynamic surroundings near the renal artery. Results: As the degree of stenosis increases and the stenosis position is far away from the aorta, there is a decrease in renal perfusion. An analysis of the wall shear stress (WSS)-related parameters indicated areas near the renal artery (downstream of the stenosis and the entrance of the right renal artery) with potential long-term risks of thrombosis and inflammation. Conclusion: The position and degree of stenosis play a significant role in judging short-term risks associated with renal perfusion. Moreover, clinicians should consider not only short-term risks but also independent long-term risk factors, such as certain regions of 50% stenosis with adequate renal perfusion may necessitate prompt intervention.

Keywords: computational fluid dynamics; hemodynamics; renal artery stenosis; renal perfusion.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Normal and stenosis model diagram.
Figure 2
Figure 2
Boundary conditions. (a) Inlet velocity waveform, (b) Outlet pressure waveforms.
Figure 3
Figure 3
Velocity distributions at the peak pressure (front view).
Figure 4
Figure 4
The perfusion of each outlet of the model. (a) Right renal artery, (b) Left renal artery, (c) Right iliac artery, (d) Left iliac artery.
Figure 5
Figure 5
Distribution of time-averaged wall shear stress (TAWSS; front view).
Figure 6
Figure 6
Distribution of oscillatory shear index (OSI) > 0.25 (back view).
Figure 7
Figure 7
Distribution of OSI > 0.25 (front view).
Figure 8
Figure 8
Distribution of relative residence time (RRT) > 5 Pa−1 (renal artery in back view).
Figure 9
Figure 9
Distribution of RRT > 5 Pa−1 (aorta in front view).
Figure 10
Figure 10
Short-term and long-term risk diagram of renal artery stenosis (the number represents the short-term risk level associated with renal perfusion; the red area represents the long-term risk associated with the WSS-related parameters).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Malone A., Chari D., Cournane S., Naydenova I., Fagan A., Browne J. Investigation of the Assessment of Low Degree (<50%) Renal Artery Stenosis Based on Velocity Flow Profile Analysis Using Doppler Ultrasound: An in-Vitro Study. Phys. Medica-Eur. J. Med. Phys. 2019;65:209–218. doi: 10.1016/j.ejmp.2019.08.016. - DOI - PubMed
    1. Lao D., Parasher P.S., Cho K.C., Yeghiazarians Y. Atherosclerotic Renal Artery Stenosis-Diagnosis and Treatment. Mayo Clin. Proc. 2011;86:649–657. doi: 10.4065/mcp.2011.0181. - DOI - PMC - PubMed
    1. Dubel G.J., Murphy T.P. The Role of Percutaneous Revascularization for Renal Artery Stenosis. Vasc. Med. 2008;13:141–156. doi: 10.1177/1358863x07085408. - DOI - PubMed
    1. Hansen K.J., Edwards M.S., Craven T.E., Cherr G.S., Jackson S.A., Appel R.G., Burke G.L., Dean R.H. Prevalence of Renovascular Disease in the Elderly: A Population-Based Study. J. Vasc. Surg. 2002;36:443–450. doi: 10.1067/mva.2002.127351. - DOI - PubMed
    1. Derkx F.H., Schalekamp M.A. Renal Artery Stenosis and Hypertension. Lancet Lond. Engl. 1994;344:237–239. doi: 10.1016/S0140-6736(94)93002-3. - DOI - PubMed