Abstract
Renal artery stenosis (RAS) and renal complications emerge in some patients after endovascular
aneurysm repair (EVAR) to treat abdominal aorta aneurysm (AAA). The mechanisms
for the causes of these problems are not clear. We hypothesized that for EVAR
patients, lower limb exercise could negatively influence the physiology of the renal artery
and the renal function, by decreasing the blood flow velocity and changing the hemodynamics
in the renal arteries. To evaluate this hypothesis, pre- and post-operative models of the
abdominal aorta were reconstructed based on CT images. The hemodynamic environment
was numerically simulated under rest and lower limb exercise conditions. The results revealed
that in the renal arteries, lower limb exercise decreased the wall shear stress (WSS),
increased the oscillatory shear index (OSI) and increased the relative residence time
(RRT). EVAR further enhanced these effects. Because these parameters are related to artery
stenosis and atherosclerosis, this preliminary study concluded that lower limb exercise
may increase the potential risk of inducing renal artery stenosis and renal complications for
AAA patients. This finding could help elucidate the mechanism of renal artery stenosis and
renal complications after EVAR and warn us to reconsider the management and nursing
care of AAA patients