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1.
Background Hybrid procedures including debranching of visceral and renal arteries followed by endovascular exclusion of the thoracoabdominal aortic aneurysm (TAAA) have recently been proposed as a less...  相似文献   

2.
Objective To review the advances in studies on renal denervation. Data sources References concerning renal denervation and resistant hypertension cited in this review were collected from PubMed published in English and those of renal denervation devices from official websites of device manufacturers up to January 2014. Study selection Articles with keywords "renal denervation" and "resistant hypertension" were selected. Results Renal and systemic sympathetic overactivity plays an important role in pathology of hypertension as well as other diseases characterized by sympathetic overactivity. Renal denervation is a new, catheter based procedure to reduce renal and systemic sympathetic overactivity by disruption of renal sympathetic efferent and afferent nerves through radiofrequency or ultrasound energy delivered to the endoluminal surface of both renal arteries. Although several studies have shown the efficacy and safety of renal denervation in the treatment of resistant hypertension and the potential benefit of the procedure in other diseases, Symplicity HTN 3 study, the most rigorous clinical trial of renal denervation to date, failed to meet its primary endpoint. The procedure also has other limitations such as the lack of long term, efficacy and safety data and the lack of the predictors for the blood pressure lowering response and nonresponse to the procedure. An overview of current renal denervation devices holding Conformite Europ6enne mark is also included in this review. Conclusions Renal denervation is a promising therapeutic approach in the management of resistant hypertension and other diseases characterized by sympathetic overactivity. In its early stage of clinical application, the efficacy of the procedure is still controversial. Large scale, blind, randomized, controlled clinical trials are still necessary to address the limitations of the procedure.  相似文献   

3.
Background  Some individuals have multiple renal arteries. Severe stenosis in one of the arteries may cause refractory hypertension. The detection of stenosis within one of the multiple renal arteries usually required invasive procedures, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). This study reported the application of color Doppler sonography (CDS) in the detection of severe stenosis in one of the multiple arteries.
Methods  Patients with multiple renal arteries and one of the arteries with severe stenosis were retrospectively studied. Peak systolic velocities (PSV) of renal arteries and the intrarenal CDS patterns were collected and compared. The diagnosis was confirmed by digital subtraction angiography (DSA).
Results  Four children with multiple renal arteries and one of the arteries with stenosis were investigated. They were admitted due to refractory hypertension. CDS screening identified two renal arteries in one kidney of each patient with one of the two renal arteries having stenosis >70%. The PSV of the stenosed arteries were much higher, and the intrarenal CDS patterns supplied by the stenosed arteries changed into T-P patterns.
Conclusion  Non-invasive CDS technology may be a useful method to identify severe stenosis in one of multiple renal arteries in young patients.
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4.
Small diameter renal artery refers to the renal artery with the cross-section diameter less than 5 mm, the incidence of which is approximately 8%' Small diameter renal artery is common in patients with congenital multi-branch renal arteries, diabetes and multi-coronary artery lesions. Renal artery bare-mental stent (BMS) implantation is the standard treatment for ostial renal  相似文献   

5.
Multidetector row-CT in evaluation of living renal donors   总被引:3,自引:0,他引:3  
Background Multidetector-row CT (MDCT) has been evolving to the standard evaluating method of potential living donor in most centers, and can provide excellent details for selecting candidates and determining surgical technique.This study aimed to assess the value of MDCT in evaluation of the anatomy of living kidney donors and to reveal the prevalence of renal vascular variations in a Chinese population.Methods One hundred and four potential donors underwent MDCT and the data sets were post-processed for reformatted images with various techniques, such as maximum intensity projection (MIP), a volume-rendering technique (VR), and multiplanar reformation (MPR). Donor nephrectomies were performed on 97 candidates after MDCT evaluation with the findings during surgery constituting the standard of reference. Resulting MDCT images were compared with actual anatomy found during surgery. Results The MDCT images accurately displayed the anatomic structure of the main renal arteries and veins as well as the upper ureters, except in one case with horseshoe kidney. The prevalence of accessory arteries revealed in images was 27.2% (28/103) and early branching was found in 12.6% (13/103). Compared with findings during surgery, the detection of accessory arteries in MDCT images was 85.7% (6/7), and the detection of larger accessory arteries (〉1.5 mm in diameter) was 100%. Detection of early branching was 100%.Conclusion MDCT helps accurately evaluate the renal anatomy of potential donors thus facilitating the planning of surgery.  相似文献   

6.
Objective To discuss the safety and feasibility of aneurysm repair in vitro and renal revascularization and renal autogenoua transplantation for complex renal artery aneurysm in solitary kidney. Methods A complex hilar renal artery aneurysm involving the bifurcantion of renal artery and its branches in a solitary left kidney was diagnosed by computed tomography angiography (CTA). After temporary nephrectomy, aneurysm repair in vitro and renal revascularization were done with the kidney protected by hypothennia and continuous perfusion with preservation solution, and then the kidney was replanted into the right iliac fossa. Results The operation was done successfully and there were no significant perioperative complications. Although a serum creatinine level temporarily exceeded above 200 μmol/L after the surgery, it recovered gradually within half a month. CTA two weeks later demonstrated patent reconstructed renal arteries and its branches and patent renal vein in the right iliac fossa, and also a patent reconstructed ureter. Conclusion This technique is safe and feasible to manage complex renal artery aneurysm in solitary kidney and provide an alternative for similar complex renal diseases. 8 refs. 6 figs.  相似文献   

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The atherosclerotic lesions from 4 major epicardial coronary arteries (left main, left anterior descending, left circumflex and right coronary arteries) of 23 nonagenarians patients were compared with that from 23 patients aged 60?9. The arteries were cut into transversely 5 mm long segments and were examined by microscope. The inside circumferences of the lumen were measured by computerized morphometric analysis. The results showed that the numbers of atherosclerotic plaques, percentages of narrowing of the coronary arterial lumen and circumferences of the arterial lumen in both groups were similar. But there were much more fibrous and resting (silent) or regressive plaques in the group aged 90-99 years as well as less lipid and active or progressive plaques than those in the group of 60-69 years. The above morphological findings may be correlated with the fact that there was a similar incidence of coronary heart disease but a less risk of acute myocardial infarction in patients aged 90?9 years than th  相似文献   

10.
The safety and efficacy of retroperitoneoscopic microwave ablation (MWA) in the treatment of renal hamartoma were evaluated.From July 2007 to July 2009, a total of 16 cases of renal hamartoma were treated with retroperitoneoscopic MWA.Peri-and post-operative findings were observed.Middle-term efficacy was assessed by contrast-enhanced computerized tomography (CT) in follow-up period.All patients received MWA of 1-5 points.The mean operative time was 85 min and the mean blood loss was 65 mL.During a median follow-up of 16 months, no evidence of disease recurrence was observed despite of incomplete ablation in 1 case.Retroperitoneoscopic MWA is a relatively simple procedure with less impact to renal function and less complication.The outcome of middle-term follow-up is satisfactory.Thus, retroperitoneoscopic MWA appears to be a safe and effective technique for renal hamartoma in selected patients.  相似文献   

11.
目的比较经不同穿刺途径行经皮冠状动脉介入术的优缺点。方法选择冠心病患者132例,随机分为3组,肱动脉组、桡动脉组和股动脉组,比较3组患者平均术后住院时间、插入冠状动脉成功率、穿刺部位血肿发生率、迷走反射发生率等指标。结果肱动脉组和桡动脉组平均术后住院时间与股动脉组间差别均有显著性意义(P<0.01),肱动脉组和桡动脉组血肿及迷走反射发生率较股动脉组少(P<0.05)。3组患者插入冠状动脉的成功率间差别无显著性意义(P>0.05)。结论经肱动脉、经桡动脉与传统的经股动脉途径一样安全可行,且并发症更少,经济实用,更易为患者所接受。  相似文献   

12.
在102例教学用过的下肢标本上,对腘动脉及小腿动脉进行了观察: 1.成人腘动脉的平均长度为17.36±1.17cm。膝上内动脉和膝上外动脉分别起白有腘动脉中段上1/3和中段中1/3各有40.59%和46.53%。膝下内动脉和膝下外动脉起自下段上1/3各有32.35%和36.37%。膝中动脉起自膝上外动脉38.78%。 2.腘动脉均在腘肌下缘分为胫前动脉和胫后动脉。胫后动脉在其始部的下方2.4±8.1cm处分出腓动脉,后者有3.92±1.92%特别发育,并代替胫后动脉分布。 3.测量小腿动脉的管径及与主干所呈角度。  相似文献   

13.
目的总结我院15例经肱动脉行同侧椎动脉支架成形术的经验,评估其可行性、安全性及成功率,为临床中进行椎动脉支架成形术提供一个新的手术入路。方法选取同期存在行椎动脉支架成形术治疗指征的患者共30例,按入路血管分为经肱动脉入路组及经股动脉入路组,各15例。比较两组椎动脉狭窄改善情况、穿刺成功率、手术成功率及并发症发生率。结果两组患者均顺利进行椎动脉支架植入术,两组穿刺成功率均为100%,手术成功率均为100%,差异无统计学意义(P0.05)。两组患者术中支架膨胀均良好,术后狭窄处血管改善情况均良好。且术后两组患者均无一例发生穿刺部位血肿。经肱动脉入路组术前椎动脉平均狭窄率为86.7%,术后下降至6.7%;经股动脉入路组术前平均狭窄率为73.3%,术后下降至6.7%。两组手术前后差异均有统计学意义(P0.01),且术后存在的狭窄均10%。结论经肱动脉行同侧椎动脉支架植入术这一入路方式安全可行,手术成功率高,可作为新的血管介入方式进行介入治疗。  相似文献   

14.
本文研究了17具(34侧)成人尸体的枕动脉。对枕动脉在枕动脉沟至穿深筋膜点之间的行程、长度、管径、及其与椎动脉第三段的距离,以及椎动脉第三段的管径进行了观察测量,旨在为临床作枕动脉与椎动脉第三段吻合术提供资料。  相似文献   

15.
目的 :探讨经股动脉和桡动脉途径行冠状动脉支架植入的优缺点。方法 :选择我院 2 0 0 0年 5月到 2 0 0 3年 12月住院 180例行冠状动脉内支架植入术的病人分成股动脉 (5 5例 )和桡动脉 (12 5例 )两组 ,比较其成功率、并发症发生率 ,并进行统计学处理。结果 :手术成功率分别为 98 18%和 99 2 0 % (P >0 0 5 ) ,血管并发症分别为 30 91%和 4 8% (P <0 0 1) (不包括疼痛和导尿等非血管并发症 )。结论 :本研究提示 ,经桡动脉行冠状动脉支架植入不需卧床 ,手术成功率高 ,病人损伤小 ,止血方便 ,血管并发症少 ,节省费用 ,减少X线照射时间。安全、可行、便捷、经济。作者推荐使用桡动脉途径行冠状动脉内支架植入术。  相似文献   

16.
50例(100侧)成人尸体左、右股动脉长度为297.29±31.06mm和294.43±31.02mm,外径为5.55±1.61mm和5.42±1.42mm,左、右腘动脉长度为167.34±17.67mm和168.54±17.30mm,外径为5.48±1.17mm和5.53±1.38mm。男女间的股动脉长度及外径和腘动脉外径之差异有统计学意义。  相似文献   

17.
兔脑动脉环的解剖学观察   总被引:1,自引:0,他引:1  
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18.
经股动脉和桡动脉途径行冠状动脉造影的对照研究   总被引:3,自引:0,他引:3  
王东方  苗云江  杨波 《海南医学》2002,13(11):61-62
目的 :比较经股动脉和经桡动脉途径行冠状动脉造影的优缺点。方法 :我院 2 0 0 0年 5月到 2 0 0 2年 10月住院、择期冠状动脉造影的病人 3 0 0例 ,按股动脉途径或桡动脉途径分为两组 ,比较其使用导管数、X光照射时间、手术操作时间、成功率、并发症发生率 ,并进行统计学处理。结果 :导管使用条数分别为 2 .3条和 1.3条 (P <0 .0 1) ;X光照射时间分别为 5 .3 2± 3 .5 8min和 4.64± 3 .2 5min(P <0 .0 5 >;手术操作时间分别为 2 1.6± 10 .5min和 15 .1± 10 .2min(P <0 .0 1)。成功率分别为 98.1%和 97.9% (P >0 .0 5 ) ;血管并发症分别为 13 .1%和 3 .5 7% (P <0 .0 1) (不包括疼痛和导尿等非血管并发症 )。结论 :经桡动脉途径行冠状动脉造影不需卧床 ,病人损伤小 ,止血方便 ,血管并发症少 ,节省费用 ,减少X光照射时间。安全、可行、便捷、经济。作者推荐使用桡动脉途径行冠状动脉造影。  相似文献   

19.
刘卿卿 《医学综述》2013,19(11):1947-1950
临床上,丘脑梗死约占缺血性脑卒中的3.1%,其治疗手段主要包括扩容、抗凝、脱水和溶栓药物治疗等,但其疗效及预后较差。目前,关于丘脑梗死的研究多为回顾性研究,且有一定的局限性,无法对不同患者制订绝对有效的治疗方案和康复计划。因此,对丘脑梗死的临床症状与丘脑相应供血血管之间关系进行分析和总结,了解其相关机制,对临床诊断及治疗工作有很大帮助。  相似文献   

20.
目的观察颈动脉支架置入术(CAS)治疗颈动脉狭窄前后颈动脉超声变化及临床疗效。方法2010年1月—2013年12月收治颈动脉狭窄患者62例,均予CAS治疗,采用颈动脉超声检测CAS前后狭窄处管径及血流参数变化,并进行对比分析。结果 62例CAS中,2例手术失败改行颈动脉内膜剥脱术(CEA),其余60例均获成功,共置入支架60个。颈动脉超声检测结果发现,患侧颈动脉狭窄处术后收缩期峰值流速(PSV)、舒张期最低血流速度(EDV)明显降低,血管内径(R)、血管搏动指数(PI)和前向血流明显增大(P<0.05),术后1周时与对侧比较差异无统计学意义(P>0.05)。术后1年复查,与术后1周比较差异亦无统计学意义(P>0.05)。1年后随访,经颈动脉超声复查发现手术侧再狭窄1例(3.3%)。结论 CAS是治疗颈动脉狭窄的一种安全可靠手段,而颈动脉超声检查可在CAS前后对狭窄程度及血流动力学情况进行有效的评估。  相似文献   

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