What is the role of spiral angiography in the workup of renal artery stenosis (RAS)?

Updated: Nov 02, 2020
  • Author: Bruce S Spinowitz, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

This technique involves the use of an intravenous injection of a relatively large dose of iodinated contrast material and allows 3-dimensional reconstruction images of the renal arteries.

In 1995, Olbricht et al compared renal CT angiography with arterial digital subtraction angiography for detecting renal artery narrowing of more than 50%. [18] The CT technique showed positive and negative predictive values of 91%.

Spiral CT angiography is a useful technique that avoids arterial catheterization and produces accurate images of renal artery anatomy. This technique requires iodinated contrast material and significant time to perform the computer-based reconstruction. This technique avoids arterial puncture and, thus, the risk of atheroemboli, but it can be associated with contrast associated nephropathy, particularly in patients with preexisting chronic kidney disease.


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