Correlation of atherosclerotic renal artery stenosis with extracranial carotid and intracranial cerebral artery atherosclerosis in patients with ischemic stroke.

OBJECTIVE

This study was to evaluate the relationship of atherosclerotic renal artery stenosis (ARAS) with extracranial carotid arteries atherosclerosis (ECAS) and intracranial cerebral atherosclerosis (ICAS) in ischemic stroke (IS) patients.

METHODS

This study was a prospective cohort analysis of consecutive patients with IS who had not a history of renal artery stenosis (RAS). Abdominal aortography was performed to screen for RAS after the cerebrovascular diagnostic procedure. Multivariate logistic regression analysis was performed to investigate the association of the clinical variables with significant ARAS (≥ 50%).

RESULTS

ARAS was identified in 61 (23.1%) of all patients and 34 patients (12.9%) had significant ARAS (≥ 50%). ECAS (≥ 70%) and ICAS (≥ 50%) was found in 66 (25%) and 48 (18.2%) respectively. Patients with ECAS (≥ 70%) were more likely to have significant ARAS than patients without ECAS (28.8% vs 6.2%, p < 0.001). In multivariate analysis, only advanced age (≥ 60 years) (OR = 2.84, 95% CI 1.01-7.91) and ECAS (≥ 70%) (OR = 5.27, 95% CI 2.396-11.60) were independent risk factors for significant ARAS.

CONCLUSION

Incidental ARAS is a relatively common finding among patients with IS, and there is a close relationship between ARAS and ECAS. Abdominal aortography should be performed to identify ARAS in elderly patients with IS, especially combined with severe ECAS.