Meuse Michael A, Turba Ulku C, Sabri Saher S, Park Auh-Whan, Saad Wael E A, Angle J Fritz, Matsumoto Alan H
Department of Angiography and Interventional Radiology, University of Virginia Health, Charlottesville, VA, USA.
Tech Vasc Interv Radiol. 2010 Jun;13(2):126-33. doi: 10.1053/j.tvir.2010.02.007.
Fibromuscular dysplasia is a nonatherosclerotic and noninflammatory disease that can result in stenoses of the renal arteries and hypertension, most commonly affecting middle-aged women. Percutaneous transluminal angioplasty has long been considered the mainstay of therapy and offers high rates of improved or cured hypertension. The disease involves the mid and distal renal arteries and branchpoints and poses endovascular treatment challenges that separate fibromuscular dysplasia from atherosclerotic disease. The development of smaller balloon dilation systems offers safe and highly effective endovascular treatment options for technically difficult lesions. Newer technologies such as cutting balloons also add to the armamentarium of treatment choices, which may be useful in the setting of resistant stenoses. This article focuses on the modern technical considerations in the diagnostic evaluation and endovascular treatment of renal artery fibromuscular dysplasia.
纤维肌性发育异常是一种非动脉粥样硬化性、非炎性疾病，可导致肾动脉狭窄和高血压，最常累及中年女性。经皮腔内血管成形术长期以来一直被视为主要治疗方法，能使高血压得到显著改善或治愈。该疾病累及肾动脉中、远端及分支点，带来了血管内治疗挑战，这使得纤维肌性发育异常有别于动脉粥样硬化疾病。更小的球囊扩张系统的研发为技术上棘手的病变提供了安全且高效的血管内治疗选择。诸如切割球囊等新技术也增加了治疗选择手段，这在难治性狭窄的情况下可能会很有用。本文重点关注肾动脉纤维肌性发育异常诊断评估和血管内治疗中的现代技术考量。
