Zeller Thomas
The Department Angiology, Herz-Zentrum Bad Krozingen, Germany.
J Interv Cardiol. 2005 Dec;18(6):497-506. doi: 10.1111/j.1540-8183.2005.00092.x.
Renal artery stenosis may cause or deteriorate arterial hypertension and/or renal insufficiency. Technical improvements of diagnostic and interventional endovascular tools have lead to a more widespread use of endoluminal renal artery revascularization and extension of the indications for this type of therapy. Since the first renal artery angioplasties performed by Felix Mahler and Andreas Grüntzig in 1978, numerous single-center studies have reported the beneficial effect of percutaneous transluminal renal angioplasty, and since the early 1990's stenting of renal artery stenosis caused either by atherosclerosis or by fibromuscular dysplasia. This article summarizes the impact of technical improvements of endovascular tools on interventional techniques during the last decade and gives an overview concerning the clinical impact of renal artery revascularization. Despite the absence of sufficient randomized studies, there is nonetheless evidence that stenting of hemodynamically relevant atherosclerotic renal artery stenosis has an impact on blood pressure control, renal function, and left ventricular hypertrophy.
肾动脉狭窄可能导致或加重动脉高血压和/或肾功能不全。诊断和介入性血管内工具的技术改进已使腔内肾动脉血运重建得到更广泛应用，并扩大了这类治疗的适应症范围。自1978年费利克斯·马勒（Felix Mahler）和安德烈亚斯·格鲁恩齐格（Andreas Grüntzig）首次进行肾动脉血管成形术以来，众多单中心研究报告了经皮腔内肾动脉血管成形术的有益效果，并且自20世纪90年代初以来，对由动脉粥样硬化或纤维肌发育异常引起的肾动脉狭窄进行了支架置入术。本文总结了过去十年中血管内工具的技术改进对介入技术的影响，并概述了肾动脉血运重建的临床影响。尽管缺乏充分的随机研究，但仍有证据表明，对血流动力学相关的动脉粥样硬化性肾动脉狭窄进行支架置入术对血压控制、肾功能和左心室肥厚有影响。
