John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA 70121, USA.
Prog Cardiovasc Dis. 2009 Nov-Dec;52(3):229-37. doi: 10.1016/j.pcad.2009.09.006.
There is little debate that an untreated significant obstruction of blood flow to the kidney, most often due to atherosclerosis, is potentially hazardous to the health of patients. The treatment of atherosclerotic renovascular disease has evolved over the past 20 years from open surgery with its inherent morbidity and risk of mortality to percutaneous endovascular treatment with stents. The current debate is on the question of which patients are offered any additional advantage by revascularization for renal artery stenosis over medications alone. The primary issue is patient selection, including the most appropriate screening strategies for renal artery stenosis, which must be balanced against the risk of procedure-related complications. The goal of this paper is to explore the most appropriate utilization of revascularization with renal stent placement.
毫无疑问，未经治疗的显著肾血流量阻塞（通常是由于动脉粥样硬化引起的）对患者的健康构成潜在威胁。过去 20 年来，治疗动脉粥样硬化性肾血管疾病已从开放性手术（具有固有发病率和死亡率风险）发展到经皮腔内血管内治疗（使用支架）。目前的争论是关于对肾动脉狭窄患者进行血管重建治疗是否比单独使用药物有额外获益的问题。主要问题是患者选择，包括肾动脉狭窄的最佳筛选策略，这必须与手术相关并发症的风险相平衡。本文的目的是探讨血管重建术（肾支架置入术）的最恰当应用。
