Gu Z M, Lin G, Wang J H, Chen F Z, Ye J R
Zhongshan Hospital, Shanghai Medical University.
Chin Med J (Engl). 1991 May;104(5):363-8.
Sixteen patients with Takayasu's arteritis and a long-stenotic segment of the descending thoracic aorta and/or proximal and middle portion of the abdominal aorta, with or without renal artery stenosis, were treated by percutaneous transluminal aorto-angioplasty (PTAA). These patients might be subdivided into three groups: A. with normal renal artery, B. with severe renal artery stenosis or occlusion without treatment or with failure of dilatation, and C. with renal artery stenosis but relieved by percutaneous transluminal renal angioplasty (PTRA). It was found that the hypertension may be caused by the suprarenal aortic stenosis itself. PTAA has an excellent effect to normalize the blood pressure in Group A. The elevated blood pressure may also be decreased in various extent in the patient with severe renal artery stenosis after PTAA, but not to normal. An additional PTRA or other renal vesel reconstruction procedure is necessary in this group. No recurrence of the aorta stenosis was found by non-invasive examinations or aortography during the long-term follow-up. PTAA may be considered as the first choice for the aortic stenosis caused by Takayasu's arteritis.
16例大动脉炎患者,降主动脉长段狭窄和/或腹主动脉近段及中段狭窄,伴或不伴肾动脉狭窄,接受了经皮腔内主动脉血管成形术(PTAA)治疗。这些患者可分为三组:A组,肾动脉正常;B组,有严重肾动脉狭窄或闭塞,未接受治疗或扩张失败;C组,有肾动脉狭窄,但经皮腔内肾血管成形术(PTRA)后缓解。发现高血压可能由肾上腺上方主动脉狭窄本身引起。PTAA对A组患者使血压正常化效果极佳。PTAA后,严重肾动脉狭窄患者的血压升高也可不同程度降低,但未恢复正常。该组患者需要额外进行PTRA或其他肾血管重建手术。在长期随访中,通过无创检查或主动脉造影未发现主动脉狭窄复发。PTAA可被视为大动脉炎所致主动脉狭窄的首选治疗方法。