Background
Renal artery involvement has not received sufficient attention despite the fact that
aortic computed tomography angiography (CTA) examinations of Stanford B-type aortic
dissection patients usually show renal artery involvement [3]. To study the influence
of renal artery involvement on aortic dissection, we performed a retrospective study
on acute Stanford B-type aortic dissection patients with or without renal artery involvement
to investigate its effect on the prognosis of aortic dissection.
Methods
A total of 221 patients with acute Stanford-B type aortic dissection between January
2012 and January 2014 were enrolled. The patients were divided into a renal artery
involvement group and a non-renal artery involvement group based on aortic computed
tomography angiography (CTA) results. The clinical data of the two groups were compared.
Univariate analyses and multiple logistic regression analyses were performed to determine
risk factors related to in-hospital mortality. The effect of renal artery involvement
on the prognosis of Stanford B-type aortic dissection patients was analysed.
Results
Among the 221 patients with acute Stanford type-B aortic dissection, 100 patients
(45.2%) exhibited renal artery involvement. The percentage of patients with a past
history of hypertension in the renal artery involvement group was significantly higher
than that in the non-renal artery involvement group (84.0% vs. 74.8%, p = 0.025). The estimated glomerular filtration rate (eGFR), creatinine level, and urea
nitrogen level at admission were not significantly different between the renal artery
involvement group and the non-renal artery involvement group. The in-hospital mortality
rate in the renal artery involvement group was higher than that in the non-renal artery
involvement group; the difference in the percentage of in-hospital mortality between
these two groups was statistically significant (12.0% vs. 4.1%, p < 0.05). The results of multiple logistic regression analysis showed that renal artery
involvement was a risk factor for in-hospital mortality in acute Stanford B-type aortic
dissection patients (odds ratio (OR) = 3.536 (1.127 ∼ 11.095)). In the renal artery involvement group, the in-hospital mortality rate in
the conservative treatment group was significantly higher than that in the interventional
treatment group (30.8% vs. 5.4%, p = 0.001).
Conclusions
Although renal artery involvement was not associated with short-term renal function
damage, it was a risk factor for in-hospital mortality after acute Stanford B-type
aortic dissection.
Keywords
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Article info
Publication history
Published online: July 24, 2018
Accepted:
July 11,
2018
Received:
November 13,
2017
Identification
Copyright
© 2018 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
