Lekston Andrzej, Niklewski Tomasz, Szkodziński Jan, Gasior Mariusz, Gierlotka Marek, Chudek Jerzy, Wiecek Andrzej, Kokot Franciszek, Fijałkowski Marek, Białas Brygida, Osadnik Tadeusz, Maciejewski Bogusław, Poloński Lech
3 Klinika Kardiologii, Slaskie Centrum Chorób Serca, Zabrze.
Pol Merkur Lekarski. 2010 Apr;28(166):268-72.
Renal Angiography and IntraVascular UltraSonography (IVUS), are valuable diagnosis methods for assessment of renovascular hypertension (RVH). Endovascular techniques employing percutaneous transluminal renal angioplasty (PTRA) are effective for therapy of ischaemic nephropathy in patients with RVH. Success of PTRA is limited by a significant rate of restenosis. THE AIM OF STUDY was to compare the assessment of residual stenosis and restenosis with angiography and IVUS.
Residual stenosis after PTRA (combine with intravascular brachyterapy in 33 patients--group I) were assessed in 62 RVH patients with angiography and IVUS techniques. Both baseline and 9-month follow-up quantitative computerized angiography (QCA) and intravascular ultrasound (IVUS) analysis were performed to assess restenosis.
Residual stenosis after PTRA of atherosclerotic lesions was slightly lower with QCA than IVUS (in group I 15.49 +/- 4.69% and 18.81 +/- 4.81% and in group II 15.36 +/- 4.68% and 18.43 +/- 4.69%, respectively). The loss of lumen area in QCA assessment was slightly greater than in IVUS measurement (1.2 +/- 0.7 mm vs. 0.9 +/- 0.8 mm in group I i 1.7 +/- 0.7 mm vs. 1.5 +/- 0.8 mm in group II). The angiographic measurements of late lumen loss, diameter stenosis, and minimal lumen diameter correlated well with IVUS measurements (r = 0.81, r = 0.89 and r = 0.89 respectively).
Angiography and IVUS are equally effective methods for diagnosis and assessment of residual stenosis and restenosis after endovascular renal artery revascularisation.
肾血管造影和血管内超声检查(IVUS)是评估肾血管性高血压(RVH)的重要诊断方法。采用经皮腔内肾血管成形术(PTRA)的血管内技术对RVH患者的缺血性肾病治疗有效。PTRA的成功率受再狭窄率的显著限制。本研究的目的是比较血管造影和IVUS对残余狭窄和再狭窄的评估。
对62例RVH患者采用血管造影和IVUS技术评估PTRA术后(33例患者联合血管内近距离治疗——I组)的残余狭窄。进行基线和9个月随访的定量计算机血管造影(QCA)和血管内超声(IVUS)分析以评估再狭窄。
动脉粥样硬化病变PTRA术后残余狭窄,QCA评估略低于IVUS(I组分别为15.49±4.69%和18.81±4.81%,II组分别为15.36±4.68%和18.43±4.69%)。QCA评估的管腔面积损失略大于IVUS测量值(I组为1.2±0.7mm对0.9±0.8mm,II组为1.7±0.7mm对1.5±0.8mm)。晚期管腔损失、直径狭窄和最小管腔直径的血管造影测量值与IVUS测量值相关性良好(分别为r = 0.81、r = 0.89和r = 0.89)。
血管造影和IVUS是诊断和评估血管内肾动脉血运重建术后残余狭窄和再狭窄的等效方法。