Duplex doppler evaluation of renal arteries in patients after surgical treatment of type A aortic dissection

Abstract

Background The aim of the study was to evaluate renal arteries in patients after surgical treatment of type A aortic dissection.
Material and methods Fifty nine patients (mean age 54.3 ± ± 12.4) who previously underwent surgical aortic repair (mean time of observation 5.3 ± 3.5 year) were examined with Doppler US [ATL 5000 HDI device]. Ultrasound findings were compared with results of CT or MR, which were used as reference methods. The morphology of abdominal aortic channels, renal arteries origin (false, true or both channels) their stenosis, dissection or occlusion were assessed.
Results A persistent false lumen was present in 78% of cases. From all diagnosed patients with abdominal aortic dissection in 66.7% renal arteries originated from true channel, in 24.4% patients arteries originated from false channel were detected. Remaining 8.9 % presented arteries were supplied from both channels (ostial tear). 84% of right renal arteries and 50% of left renal arteries were originated from true channel. The false channel was supplying 11.4 % of right renal arteries versus 37% of left ones. 19.6% of left renal arteries were dissected versus 4.5% right ones. We observed 3 occlusions and 5 renal arteries stenoses.
Conclusions 78% patients after surgical treatment of type A aortic dissection had persistent false lumen in abdominal aorta. The sensitivity of US assessment of renal arteries in comparison to CT and MR scanning is high and for right renal arteries equals 95.4%, for left one 84.8%.US diagnostic accuracy enables aortic vessel evaluation in the course of abdominal aortic dissection.