支架置放术治疗18例肾动脉狭窄

目的　评估支架置放术治疗肾动脉狭窄 (RAS)的疗效与安全性。方法　对 1 8例 ( 1 9例次 )伴有高血压或肾功能不全的RAS≥5 0 %患者 (动脉粥样硬化 7例 ,大动脉炎 4例 ,纤维肌性结构不良 8例次 )进行肾动脉支架置放术 (PTRAS) ,采用门诊方式随访 3～ 41个月 (平均 1 4 5个月 ) ,观察手术对患者血压、肾功能的影响。结果　技术成功率为 1 0 0 % ,未发生并发症 ;术后第 2天疗效 :治愈 6例 ,改善 1 3例次 ;3个月疗效 :治愈 6例 ,改善 1 1例次 ,无效 2例 ;≥ 1 2个月疗效 :共 1 2例 ,治愈 3例 ,改善 9例。结论　RAS≥ 5 0 %者用PTRAS治疗安全、有效 ,对纤维肌性结构不良及大动脉炎患者的疗效较动脉粥样硬化患者好。

Stent Revascular Treatment for 18 Patients with Renal Artery Stenosis

Objective To evaluate the efficacy and safety of stent revascular treatment for renal artery stenosis(RAS).Methods Percutaneous transluminal renal angioplasty with stent (PTRAS)was performed on 18 patients (19 times) with RAS≥50% for poorly controlled hypertension or renal dysfunction including 7 renal atherosclerosis,4 arteritis and 7(8 times)fibromuscular dysplasia.Blood pressure and serum creatinine (SCR) were followed up in all patients for 14.5 months (3-41 months).Results Technical success (residual stenosis<30%) was achieved in all patients without complication.At 48 th hours after procedure,6 patients were cured,12 patients (13 times)were improved.At 3 months after procedure,6 patients were cured,10 patients (11 times) improved and 2 patinets were ineffective.Of 18 patients, 12 were followed up more than 12 months with 3 cured and 9 improved.conclusions PTRAS are safe and effective in treatment of renal artery stenosis.The efficacy of PTRAS for treating arteritis and fibromuscular dysplasia is better than for atherosclerosis.