Ingrisch H
Abteilung für Röntgendiagnostik und Nuklearmedizin, Städtisches Krankenhaus München-Bogenhausen, Akademisches Lehrkrankenhaus.
Fortschr Med. 1991 May 20;109(15):317-21.
Recanalization (angioplasty) and occlusion (embolization) are the major interventional radiological procedures used in renal vessels. In recanalization of the renal artery, percutaneous transluminal angioplasty of renal arterial stenosis is the most common procedure. About 80% of renal arterial stenoses are suitable for this procedure, that is, about 80% of patients can be spared major abdominal surgery. Methods, results and complications are discussed. Local lysis of acute renal arterial occlusions is rarely employed, since the diagnosis is usually made too late. Functional improvements may be expected even when recanalization is successful only when the procedure is performed within one hour of the occlusion or when collaterals suffice for organ-preserving metabolic activities. Embolization of the renal artery is employed in particular in the case of tumors of the kidneys, more frequently with a pre-operative rather than a palliative intent. Pre-operative embolization aims at facilitating surgery and reducing the need for transfused blood. The palliative procedure employed in inoperable tumors aims at prolonging life, controlling acute bleeds, and combatting paraneoplastic syndromes. The method is described.
再通术(血管成形术)和闭塞术(栓塞术)是肾血管介入放射学的主要操作。在肾动脉再通术中,经皮腔内肾动脉狭窄血管成形术是最常见的操作。约80%的肾动脉狭窄适合此操作,也就是说,约80%的患者可避免进行大型腹部手术。文中讨论了方法、结果及并发症。急性肾动脉闭塞的局部溶栓很少应用,因为诊断通常太晚。即使再通成功,只有在闭塞后一小时内进行该操作或侧支循环足以维持器官代谢活动时,才有望实现功能改善。肾动脉栓塞尤其用于肾脏肿瘤,更多用于术前而非姑息治疗目的。术前栓塞旨在便于手术并减少输血需求。用于无法手术切除肿瘤的姑息性操作旨在延长生命、控制急性出血并对抗副肿瘤综合征。本文对该方法进行了描述。