经皮血管成形术治疗肌纤维发育不良型肾动脉狭窄的临床疗效

目的评价经皮血管腔内血管成形术(PTA)治疗肾动脉肌纤维性发育不良的疗效及安全性。方法选择肌纤维发育不良型肾动脉狭窄患者32例(均合并2~3级高血压或难治性高血压),行经皮肾动脉成形术治疗。术后随访观察患者血压、药物治疗种类、术后再狭窄、生存率和并发症等。结果 PTA技术成功率93.94%(31/33)。术前、术后收缩压分别为(189.6±26.0)mmHg、(136.6±8.0)mmHg(t=9.117,P0.001),舒张压分别为(121.6±21.7)mmHg、(81.1±11.5)mmHg(t=7.745,P0.001)。无肾动脉破裂、夹层、分支堵塞及血栓形成等相关并发症和术后不良事件发生。术后随访时间5~100个月,平均(40.4±26.1)个月,患者生存率100%(32/32)。结论经皮血管成形术治疗肌纤维发育不良肾动脉狭窄安全、有效。

Clinical efficacy of percutaneous transluminal angioplasty in treatment of renal artery stenosis resulting from fibromuscular dysplasia

Objective To investigate the efficacy and safty of percutaneous transluminal angioplasty (PTA) of renal artery stenosis resulting from fibromuscular dysplasia. Methods A total of 32 patients with fibromuscular dysplasia complicated with hypertension in level 2 to 3 or refractory hypertension were enrolled, who underwent PTA. The blood pressure, types of medication, restenosis, survival rates and complications were observed after treatment. Results Technical success rate of PTA was 93.94% (31/33). The blood pressure decreased from (189.6±26.0)mmHg/(121.6±21.7)mmHg before operation to (136.6±8.0)mmHg/(81.1±11.5)mmHg after operation (t=9.117, 7.745, both P<0.001). No renal artery rupture, interlayer, branch blockage, thrombosis and other related complications and postoperative adverse events occurred. All patients were followed up for 5 months to 100 months, with an average of (40.4±26.1) months. Survival rate was 100% (32/32). Conclusion PTA is safe and effective for treating renal artery stenosis from fibromuscular dysplasia.