经皮肾动脉血管成形术治疗老年高血压患者的肾动脉纤维肌性发育不良。

Angioplasty for renal artery fibromuscular dysplasia in older hypertensive patients.

机构信息

Department of Cardiology, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Angiology. 2009;60(6):714-8. doi: 10.1177/0003319709335512. Epub 2009 Jul 21.

DOI:10.1177/0003319709335512

PMID:19625271

Abstract

AIM

To describe the outcomes of treating patients with angioplasty who are older than 40 years with symptomatic/labile/refractory hypertension (HTN).

METHODS

Between 1999 and 2005, 28 patients underwent angioplasty for renal fibromuscular dysplasia (FMD). Patients were excluded if they had concomitant atherosclerotic renal artery stenosis (n = 4) or less than 1 month follow-up (n = 8).

RESULTS

The study group included 16 Caucasians (21 procedures; mean age 65.5 +/- 10.8 years; females = 88%). The cardiovascular risk factors include HTN (n = 13), smoking (n = 1), diabetes (n = 2), dyslipidemia (n = 8). The HTN was characterized as refractory (n = 15, 12 were symptomatic) and new-onset in 1 patient. The technical success rate was 100%. Over a median period of 12.8 months (range: 1.0-85.8), 18 (95%) procedures ''failed,'' of which 8 (42%) within 1 month and the rest in 1 year.

CONCLUSIONS

Angioplasty in symptomatic renal FMD in patients >40 years is associated with poor outcomes possibly due to early restenosis.

摘要

目的

描述治疗年龄大于 40 岁且伴有症状性/波动性/难治性高血压（HTN）的血管成形术患者的治疗结果。

方法

1999 年至 2005 年，28 例因纤维肌性发育不良（FMD）而行血管成形术的患者纳入研究。如果患者合并有粥样硬化性肾动脉狭窄（n=4）或随访时间少于 1 个月（n=8），则将其排除在外。

结果

研究组包括 16 名高加索人（21 例手术；平均年龄 65.5+/-10.8 岁；女性 88%）。心血管危险因素包括 HTN（n=13）、吸烟（n=1）、糖尿病（n=2）、血脂异常（n=8）。HTN 表现为难治性（n=15，其中 12 例有症状）和 1 例新发。技术成功率为 100%。在中位数为 12.8 个月（范围：1.0-85.8）的随访期间，18（95%）例手术“失败”，其中 8（42%）例在 1 个月内失败，其余在 1 年内失败。