Noninvasive and Patient-Specific Assessment of True Severity of Renal Artery Stenosis for New Guidelines for Planning Stent Therapy Alan P. Sawchuk,

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Noninvasive and Patient-Specific Assessment of True Severity of Renal Artery Stenosis for New Guidelines for Planning Stent Therapy Alan P. Sawchuk, MD, Monsurul Khan, Anurag Deb, Raghu L. Motaganahalli, MD, Xin Fang, MD, Fangke Chen, MD, Huidan (Whitney) Yu, PhD Journal of Vascular Surgery Volume 68, Issue 3, Pages e64-e65 (September 2018) DOI: 10.1016/j.jvs.2018.06.062 Copyright © 2018 Terms and Conditions

Fig 1 a, Schematic of InVascular used to extract three-dimensional aortorenal artery anatomy based on computed tomography (CT) angiography and to quantify the trans-stenotic pressure gradient (Pa-Pr) combining Doppler ultrasound flow condition at the inlet and three-element Windkessel model at the exits. b, Parametric deterioration scenarios of stenosis measured from the volume reduction of the renal lumen. c, Determination of mild (S ≤ Smm), moderate (Smm< S ≤ Sms), or severe (S > Sms) stenosis based on the trans-stenotic pressure gradient of the existing stenosis (S). Journal of Vascular Surgery 2018 68, e64-e65DOI: (10.1016/j.jvs.2018.06.062) Copyright © 2018 Terms and Conditions

Fig 2 Correlation of (a) systolic trans-stenotic pressure gradient ΔP and (b) normalized mass flow ratio from aorta to renal artery vs volumetric stenosis degree S of four renal arteries recognized by the four colors. The characteristic stenosis sizes Smm and Sms that indicate mild, moderate, and severe renal artery stenosis (RAS) are shown in (a), and ischemia ranges due to the severe RAS are identified in (b). Journal of Vascular Surgery 2018 68, e64-e65DOI: (10.1016/j.jvs.2018.06.062) Copyright © 2018 Terms and Conditions