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大动脉炎所致肾动脉狭窄的慢性完全闭塞与药物洗脱支架置入成功

Chronic total occlusion and successful drug-eluting stent placement in Takayasu arteritis-induced renal artery stenosis.

作者信息

Agarwal Guarav, Vats Hemender S, Raval Amish N, Yevzlin Alexander S, Chan Micah R, Gimelli Giorgio

机构信息

Corresponding Author: Hemender S. Vats, Clinical Associate Professor, University of Wisconsin, School of Medicine and Public Health, Rm 130, Mc9580 Wisconsin Dialysis, Inc, 3034 Fish Hatchery Rd, Madison, WI 53713.

出版信息

Clin Med Res. 2013 Dec;11(4):233-6. doi: 10.3121/cmr.2013.1132. Epub 2013 May 8.

Abstract

Takayasu arteritis-induced renal artery stenosis (TARAS) is a condition rarely described in the literature. Although percutaneous transluminal angioplasty and stenting has been well-described in the treatment of atherosclerotic renal artery stenosis, its role has not been established in non-atherosclerotic TARAS. We report a case of a female, age 17 years, with Takayasu arteritis who presented to the hospital with seizures and hypertensive crisis. A renal angiogram showed chronic total occlusion (CTO) of the left renal artery. Renal angioplasty and stenting was successfully performed after multiple attempts to deliver a wire distal to the CTO. After sequential balloon predilation, a drug-eluting stent was deployed, resulting in full reperfusion of the kidney. The patient's blood pressure improved dramatically, and patency of the stent was demonstrated with magnetic resonance angiography over 9 months after the procedure.

摘要

高安动脉炎所致肾动脉狭窄(TARAS)在文献中鲜有描述。尽管经皮腔内血管成形术和支架置入术在治疗动脉粥样硬化性肾动脉狭窄方面已有详尽报道,但其在非动脉粥样硬化性TARAS中的作用尚未明确。我们报告一例17岁女性高安动脉炎患者,因癫痫发作和高血压危象入院。肾血管造影显示左肾动脉慢性完全闭塞(CTO)。在多次尝试将导丝送达CTO远端后,成功进行了肾血管成形术和支架置入术。经序贯球囊预扩张后,置入药物洗脱支架,使肾脏完全再灌注。患者血压显著改善,术后9个月磁共振血管造影显示支架通畅。

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本文引用的文献

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Renovascular hypertension and ischemic nephropathy.肾血管性高血压和缺血性肾病。
Circulation. 2005 Aug 30;112(9):1362-74. doi: 10.1161/CIRCULATIONAHA.104.492348.
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Takayasu's arteritis.高安动脉炎
Lancet. 2000 Sep 16;356(9234):1023-5. doi: 10.1016/S0140-6736(00)02701-X.
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Results of renal angioplasty in nonspecific aortoarteritis (Takayasu disease).
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