Tanemoto Masayuki, Takase Kei, Yamada Takayuki, Satoh Akihiro, Abe Takaaki, Ito Sadayoshi
Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Hypertens Res. 2007 Oct;30(10):999-1002. doi: 10.1291/hypres.30.999.
Transluminal angioplasty with a balloon catheter is effective to dilate renal artery stenosis (RAS) caused by fibromuscular dysplasia (FMD), but lesions resistant to the angioplasty exist. In this report, we describe the case of a young woman with RAS of FMD that was difficult to dilate even by cutting-balloon angioplasty. To facilitate the formation of a smooth intimal covering at the site of angioplasty, we administered losartan, an angiotensin receptor blocker, for 4 months after the angioplasty. Although re-stenosis was detected at 5 months after the angioplasty, the normotensive state continued without antihypertensives and the re-stenosis gradually dilated afterwards. The present case suggests the possibility of remodeling the renal artery during the normotensive state by administering losartan after the angioplasty.
使用球囊导管进行腔内血管成形术可有效扩张由纤维肌发育不良(FMD)引起的肾动脉狭窄(RAS),但存在对血管成形术有抵抗的病变。在本报告中,我们描述了一名患有FMD所致RAS的年轻女性病例,即使采用切割球囊血管成形术也难以扩张。为促进血管成形术部位形成光滑的内膜覆盖,我们在血管成形术后给予血管紧张素受体阻滞剂氯沙坦4个月。尽管在血管成形术后5个月检测到再狭窄,但在未使用抗高血压药物的情况下血压正常状态持续存在,并且再狭窄随后逐渐扩张。本病例提示血管成形术后给予氯沙坦可能在血压正常状态下重塑肾动脉。