血管内超声显像在肾动脉介入治疗中的应用价值

评价血管内超声显像在肾动脉介入治疗中的应用价值。 15例显著肾动脉狭窄 (内径减少 >5 0 % )患者在肾动脉介入术前、术后接受肾动脉内血管超声检查。所有患者均接受肾动脉支架术治疗 (共植入 15枚支架 ) ,所选支架直径均根据术前血管内超声图像定量计算所得肾动脉参考直径选择。结果发现 ,15例患者中 13例肾动脉病变由硬性斑块构成 ,其中 2例伴严重钙化 ,剩余 2例为软斑块。血管重构方式 12例表现为负性重构 ,3例为正性重构。病变血管外弹力膜横截面积为 119.7± 2 3.1mm2 ,管腔横截面积为 34.5± 9.3mm2 ,斑块面积为 85 .2± 2 6 .0mm2 。肾动脉支架术治疗手术成功率为 10 0 %。结果提示 ,肾动脉血管内超声检查在判定肾动脉斑块性质、明确狭窄程度、测量管腔直径及指导支架植入有重要临床价值。

Clinical Efficacy of Intravascular Ultrasound in Patients Undergoing Renal Interventional Therapy

Aim To evaluate the efficacy of intravascular ultrasound (IVUS) in patients undergoing renal artery intervention therapy. Methods 15 consecutive patients with significant renal artery stenosis (luminal narrowing of renal artery > 50%) underwent IVUS, before and after renal artery stenting. All patients underwent renal artery stenting, the sizes of the stent were chosen according to the results of IVUS. Results IVUS revealed 13 hard plaques with 2 severe calcification and 2 soft plaques in 15 patients; 12 lesions were found with negative remodeling, 3 with positive remodeling. The mean cross sectional areas of external elastic membrane and lumen were 119.7±23.1 mm 2 and 34.5±9.3 mm 2. The mean plaque area was 85.2±26.0 mm 2. All patients underwent renal artery stenting with 100% successful procedure rates. Conclusions IVUS has superiority in determining the lesion characteristics, defining the stenosis, calculating the luminal dimension and inserting the stent.