3rd Department of Cardiology, Silesian Center for Heart Disease, Zabrze, Poland.
Cardiol J. 2009;16(6):514-20.
Scarce data exist concerning the long-term effect of percutaneous transluminal renal angioplasty (PTRA) enhanced with intravascular gamma brachytherapy (IVBT) in patients with renovascular hypertension.
Seventy one patients aged 52 +/- 8 years with refractory renovascular hypertension were randomized to Group I (PTRA + IVBT) or Group II (PTRA). For the IVBT procedure, the PARIS catheter and Microselectron HDR (Nucletron) system was employed. Both baseline and 9-month follow-up quantitative computerized angiography (QCA) and ambulatory blood pressure monitoring analysis was performed to assess luminal parameters of restenosis and the effect of treatment on blood pressure.
Thirty three patients from Group I and 29 patients from Group II underwent successful procedure. During nine months of follow-up, three patients died; including two patients in Group I (cardiac causes) and one patient in Group II (stroke). The follow-up lumen diameter stenosis was 30.6 +/- 13.7% and 40.4 +/- 11% in Groups I and II, respectively (p = 0.004). Late lumen loss in quantitative computerized angiography was 1.2 +/- 0.7 mm and 1.7 +/- 0.7 mm in Groups I and II, respectively (p = 0.004).
Intravascular gamma brachytherapy using self-centering source performed after balloon angioplasty is a safe and effective method of prevention of restenosis after PTRA in patients with renovascular hypertension.
经血管内伽玛照射增强的经皮腔内肾血管成形术（PTRA）治疗肾血管性高血压患者的长期效果数据有限。
71 名年龄 52 ± 8 岁的难治性肾血管性高血压患者被随机分为 I 组（PTRA+IVBT）或 II 组（PTRA）。IVBT 采用 PARIS 导管和 Microselectron HDR（Nucletron）系统。进行基线和 9 个月的随访定量计算机血管造影（QCA）和动态血压监测分析，以评估再狭窄的管腔参数和治疗对血压的影响。
I 组 33 例和 II 组 29 例患者成功进行了手术。在 9 个月的随访期间，3 例患者死亡；其中 I 组 2 例（心脏原因）和 II 组 1 例（中风）。随访时管腔直径狭窄率分别为 I 组 30.6±13.7%和 II 组 40.4±11%（p=0.004）。QCA 显示晚期管腔丢失分别为 I 组 1.2±0.7mm 和 II 组 1.7±0.7mm（p=0.004）。
在球囊血管成形术后使用自定心源进行血管内伽玛照射是预防肾血管性高血压患者 PTRA 后再狭窄的一种安全有效的方法。
