肾动脉支架成形术两种置入途径的疗效比较

 目的 对比经肱动脉和经股动脉途径行肾动脉支架成形术(percutaneous transluminal renal artery stenting，PTRAS)安全性及有效性。方法 回顾性分析132例接受PTRAS的肾动脉狭窄(renal artery stenosis，RAS)患者，比较经肱动脉与经股动脉途径完成操作患者的临床资料、介入手术参数及结果。结果 所有入选患者(n=132)术前收缩压(150.72±22.57 )mmHg与术后收缩压(136.67±20.43)mmHg相比明显下降，差异具有统计学意义(t=4.974， P<0.01);术前舒张压(81.46±12.19)mmHg与术后舒张压(76.52±10.45) mmHg相比也有明显下降，差异有统计学意义(t=4.418， P<0.01)。术后6个月所有入选患者门诊随访收缩压(132.20±20.42)mmHg与术前相比明显下降，差异有统计学意义(t=18.523， P<0.01);门诊随访舒张压(74.22±10.57)mmHg与术前相比明显下降，差异有统计学意义(t=7.242， P<0.01)。两组靶病变狭窄程度、平均支架长度、平均置入支架直径、穿刺部位出血并发症、平均手术时间、造影剂用量比较，差异均无统计学意义(P>0.05)。结论 行PTRAS时，肱动脉途径是股动脉途径有效替代方式。

Comparative study of the efficacy of transbrachial and transfemoral approaches for percutaneous renal artery stenting

Objective To compare the safety and efficacy of transbrachial and transfemoral approaches for percutaneous renal artery stenting (PTRAS).Methods The clinical data of 132 patients with renal artery stenosis (RAS) who underwent PTRAS were retrospectively analyzed. The clinical data and interventional operation parameters of patients treated with brachial artery and femoral artery were compared.Results The preoperative systolic blood pressure (150.72±22.57) mmHg in all patients (n=132) significantly decreased compared with the postoperative systolic blood pressure (136.67±20.43) mmHg (t=4.974, P<0.01). And the difference was statistically significant (t=4.418, P<0.01) between the preoperative diastolic blood pressure (81.46±12.19) mmHg and the postoperative diastolic blood pressure (76.52±10.45) mmHg. Six months after operation, all patients were followed up, compared with the preoperative, the systolic blood pressure (132.20±20.42) mmHg and the diastolic blood pressure(74.22±10.57)mmHg significantly decreased, and the difference was statistically significant (P<0.01). There was no significant difference between the two groups in the degree of stenosis, the average length of the stent, the average diameter of the stent, the bleeding complications, the average operation time and the dosage of the contrast agent.Conclusions The transbrachial approach is an effective alternative transfemoral approach in the PTRAS.