肾动脉型大动脉炎的外科治疗

肾动脉型大动脉炎造成的难治性高血压及肾功能不全是大动脉炎药物治疗的难点,临床面临难治性肾血管性高血压且肾动脉狭窄程度≥70%时,应积极考虑行外科手术治疗。可选择的治疗方式有开放手术或介入治疗,但目前对于术式的选择尚无明确指南。本文总结了开放手术、球囊扩张术、支架置入术的临床效果、长期通畅率及并发症发生率,旨在为肾动脉型大动脉炎的临床手术术式选择提供参考。

Surgical Treatments of Renal Artery Stenosis in Takayasu Arteritis

Refractory hypertension and renal insufficiency caused by Takayasu arteritis with renal arteries involved are difficult to treat with medicines.Instead,surgery is often recommended for refractory renovascular hypertension with renal artery stenosis of ≥70%.Although both open surgery and endovascular surgery have been applied,the preferred surgical strategy remains undetermined.This article reviews the clinical effectiveness,long-term patency,and complications of open surgery,percutaneous balloon angioplasty,and stenting in patients with Takayasu arteritis-associated renal artery stenosis.