与单纯接受支架治疗的患者相比，接受带有栓塞保护装置的支架置入术治疗的肾动脉狭窄患者的临床结局。
Clinical outcomes in patients with renal artery stenosis treated with stent placement with embolic protection compared with those treated with stent alone.
作者信息
Khosla Ankaj, Misra Sanjay, Greene Eddie L, Pflueger Axel, Textor Steve C, Bjarnason Haraldur, McKusick Michael A
机构信息
Department of Radiology, School of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
出版信息
Vasc Endovascular Surg. 2012 Aug;46(6):447-54. doi: 10.1177/1538574412449911. Epub 2012 Jun 11.
PURPOSE
To compare the clinical outcomes in patients with chronic renal insufficiency (CRI) and renal artery stenosis (RAS) following renal artery (RA) stent placement with and without embolic protection device (EPD) usage.
MATERIALS AND METHODS
Eighteen patients who had RA stent placement with EPD were matched to control patients (RA stent only). Blood pressure, number of hypertensive medications, and estimated glomerular filtration rate (eGFR) at 3 months before the procedure and after 12 months were determined. An increase of ≥ 20% in eGFR at 12 months from baseline was defined as "improvement," decrease of ≥ 20% as "deterioration," and an eGFR change between those values as "stabilization" at 12 months.
RESULTS
At 12 months, stage 4 patients treated with EPD had significantly higher eGFR than controls (P = .01). There was no statistical difference in blood pressure outcomes between the 2 groups.
CONCLUSIONS
Patients with stage 4 CRI did significantly better with EPD than those treated without it.
目的
比较使用和不使用栓塞保护装置（EPD）进行肾动脉（RA）支架置入术后，慢性肾功能不全（CRI）合并肾动脉狭窄（RAS）患者的临床结局。
材料与方法
将18例使用EPD进行RA支架置入的患者与对照患者（仅行RA支架置入）进行匹配。测定术前3个月及术后12个月的血压、抗高血压药物数量和估计肾小球滤过率（eGFR）。12个月时eGFR较基线水平升高≥20%定义为“改善”，降低≥20%定义为“恶化”，介于两者之间的eGFR变化定义为12个月时“稳定”。
结果
12个月时，使用EPD治疗的4期患者eGFR显著高于对照组（P = 0.01）。两组血压结局无统计学差异。
结论
4期CRI患者使用EPD的效果明显优于未使用者。
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