动脉粥样硬化性缺血性肾病的血管内介入方法选择和疗效探讨

目的评价动脉粥样硬化性肾动脉狭窄血管内介入治疗的方法和临床疗效。方法28例肾动脉狭窄采用导引导管法(A组19例)和导丝交换法(B组9例)，行经皮肾动脉内支架成形术，共植入支架31枚(Palmaz支架22枚，Wallstent4枚，Symphony支架5枚)。随访6个月～1年，观察血压、血肌酐、抗高血压药用药情况，并与术前比较。结果两组肾动脉内支架成形术技术成功率为100％，B组中有2例患者术中发生肾动脉远端分支栓塞，两组共有4支血管发生再狭窄。结论导引导管法肾动脉内支架是动脉粥样硬化性肾动脉狭窄介入治疗首选方法；维护肾功能是该治疗的首要目的。

Evaluating the methods and effects of intravascular interventional therapy of atherosclerotic ischemic nephropathy

Objective To evaluate the effects and methods of interventional therapy of the atherosclerotic renal artery stenosis(ARAS).Methods 28 cases of ARAS were implanted with stents by guiding catheter or guidewire exchanging, 31 stents were implanted (Palmaz stent in 22, Wallstent in 4, and Symphony stent in 5). Follow up was undertaken for 6 months to 1 year, together with recording the blood pressure, creatinine, the effective number of antihypertensive medication and comparing with those before the procedure. Results Stents were implanted successfully in all cases. Complication of renal arterial embolism happened in 2 cases with recanalization by guidewire exchanging. Restenosis happened in 4 cases.Conclusion Stent implantation for renal artery stenosis by guiding catheter is an ideal method or probably the chief interventional therapy to preserve the renal function.