Rees C R, Palmaz J C, Becker G J, Ehrman K O, Richter G M, Noeldge G, Katzen B T, Dake M D, Schwarten D E
Department of Radiology, University of Texas Health Science Center, San Antonio.
Radiology. 1991 Nov;181(2):507-14. doi: 10.1148/radiology.181.2.1924796.
Palmaz balloon-expandable stents were placed in 28 hypertensive patients with atherosclerosis involving the ostia of the renal arteries. Stents were placed to treat elastic recoil immediately after conventional angioplasty in 20 patients and restenosis after percutaneous transluminal angioplasty in eight patients. Technical success (greater than 30% residual stenosis) was achieved in 27 patients. Complications occurred in five patients. At follow-up (1-25 months), hypertension was cured in three patients and improved in 15 patients, with a cumulative cure or improvement of 64% at 6 months. Of 14 patients with a serum creatinine level of 1.5 mg/dL (132.6 mumol/L) or greater before the placement of stents, five demonstrated improved renal function, five showed stabilization of their condition, and four demonstrated deterioration. Follow-up angiography (2-18 months) was performed in 18 patients. Restenosis was present in seven patients and was accompanied by a relapse of hypertension in only three patients. Of the other four patients with restenosis, two had no initial improvement and two had an initial response without a relapse of hypertension. In this preliminary study, renal stents were beneficial in many patients with poor results from conventional angioplasty for ostial atheroma.
将Palmaz球囊扩张式支架植入28例患有累及肾动脉开口处动脉粥样硬化的高血压患者体内。在20例患者中,支架在传统血管成形术后立即植入以治疗弹性回缩,在8例患者中,支架用于治疗经皮腔内血管成形术后的再狭窄。27例患者获得技术成功(残余狭窄大于30%)。5例患者出现并发症。随访(1 - 25个月)时,3例患者高血压治愈,15例患者病情改善,6个月时累积治愈或改善率为64%。在支架植入前血清肌酐水平为1.5 mg/dL(132.6 μmol/L)或更高的14例患者中,5例肾功能改善,5例病情稳定,4例病情恶化。18例患者进行了随访血管造影(2 - 18个月)。7例患者出现再狭窄,其中仅3例患者伴有高血压复发。在其他4例再狭窄患者中,2例最初无改善,2例最初有反应但无高血压复发。在这项初步研究中,对于因开口处动脉粥样硬化导致传统血管成形术效果不佳的许多患者,肾动脉支架是有益的。