Renal atrophy following aortic repair is difficult to be identified through renal function biochemical measures due to compensation. Computational fluid dynamics (CFD) analysis is a promising approach for identifying anomalies of renal blood supply, which is related to renal atrophy. This study reports 3 patients who underwent renal atrophy after aortic repair during follow-up. The hemodynamics of renal arteries in each case was analyzed through employing the CFD method. The pressure ratio (PR; renal artery-to-aorta) measurements revealed significantly lower values on the atrophic side of the renal artery when comparing to the nonatrophic side. PR is promising to serve as an early quantitative indicator, with persistent depression prior to obvious morphological atrophy. Serial CFD-based PR assessments show promise in predicting the risk of renal atrophy and facilitating earlier intervention. Patient-specific CFD simulations based on computed tomography angiography offer hemodynamic profiling to detect perfusion compromise in the preclinical phases.
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