Salvadori M, Di Maria L, Rosati A, Larti A, Piperno R, Becherelli P, Bandini S, Biagini M, Filocamo M T, Gallo M, Bertoni E
Renal Unit, Careggi University Hospital, Florence, Italy.
Transplant Proc. 2005 Mar;37(2):1047-8. doi: 10.1016/j.transproceed.2004.12.229.
To verify the long-term efficacy and safety of Palmaz stent implantation in the treatment of transplant renal artery stenosis (TRAS), we reviewed the charts of 26 patients affected by TRAS and treated by percutaneous transluminal angioplasty (PTA) followed by permanent insertion of a Palmaz stent. The mean follow-up period was 43.31 +/- 33.6 months. The mean blood pressure fell significantly at 1 month after stenting (118 +/- 8.1 vs 101 +/- 7.8 mmHg; P < .0001); then remained stable. Renal artery blood flow, as determined by Doppler ultrasonography, was reduced from 352.5 +/- 56.5 to 157.3 +/- 53.7 cm/sec at 1 month after stenting (P < .0001). Renal function improved after stenting (serum creatinine 2.2 +/- 1.4 mg/dL preinsertion versus 1.72 +/- 1.05 at 3 years). In conclusion, in cases of severe or recurrent TRAS, stenting of the renal artery has proved to be an effective therapeutic tool. This method, which has low procedure costs and an extremely low complication rate has proved to be safe and to offer the potential of preserving luminal patency, improving the long-term efficacy of percutaneous angioplasty.
为验证帕尔马兹支架植入术治疗移植肾动脉狭窄(TRAS)的长期疗效和安全性,我们回顾了26例患有TRAS且接受经皮腔内血管成形术(PTA)并永久性植入帕尔马兹支架治疗的患者病历。平均随访期为43.31±33.6个月。支架植入后1个月平均血压显著下降(118±8.1 vs 101±7.8 mmHg;P<.0001);随后保持稳定。通过多普勒超声测定,支架植入后1个月肾动脉血流从352.5±56.5降至157.3±53.7 cm/秒(P<.0001)。支架植入后肾功能改善(术前血清肌酐2.2±1.4 mg/dL,3年后为1.72±1.05)。总之,在严重或复发性TRAS病例中,肾动脉支架植入已被证明是一种有效的治疗手段。这种方法手术成本低且并发症发生率极低,已被证明是安全的,并具有保持管腔通畅、提高经皮血管成形术长期疗效的潜力。