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Renal Artery Stenosis Diagnosis Criteria
Jul 25, 2024
Renal Artery Stenosis and Diagnosis Criteria
Key Concepts:
Importance of Color Doppler and Spectral Doppler
Velocity criteria: Use 180 cm/s as a benchmark.
If turbulence is found in the main renal arterial segment, place a spectral Doppler on that area.
Renal to Aortic Ratio (RAR)
Why RAR is needed?
Unlike peripheral or carotid arteries, renal artery stenosis often occurs at the origin, especially in elderly patients.
No proximal renal artery segment is usually available for comparing flow velocity.
Procedure: Compare PSV
Compare the Proximal Segment Velocity (PSV) of the aorta to the PSV at the stenotic segment of the renal artery.
Interpretation in Elderly Patients
Low Cardiac Output Consideration
Elderly patients may have heart disease leading to lower overall cardiac output.
Example: Aortic PSV could be 35-40 cm/s.
Renal artery PSV at the stenosis area may be 140 cm/s.
Ratio Standards
Even if renal artery PSV doesn't meet the 180 cm/s criteria, a ratio >3.5 between renal artery PSV and aortic PSV still indicates stenosis.
Summary
Summary
: Use a combination of absolute velocity and relative velocity (RAR) for accurate diagnosis of renal artery stenosis.
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