Puijlaert C B, Klinge J, Mali W P, Geyskes G G, Kouwenberg J J
Ned Tijdschr Geneeskd. 1989 Feb 25;133(8):400-4.
Two hundred and thirteen patients with hypertension and renal artery stenosis were treated with percutaneous transluminal renal angioplasty (PTRA). The angiographic appearance was typical of atherosclerosis in 134 patients and of fibromuscular dysplasia (FMD) in 52 patients, and could not reliably be classified in one of these groups in 27. In these patients 272 renal artery stenoses were treated. In 81% of these patients the PTRA was technically successful. The antihypertensive result in this group of 210 patients was positive (cure or improvement) in 80%. The life-table results after 5 years show cure or improvement in the atherosclerotic group (n = 35) in 80.27%, in the FMD group (n = 20) in 88.83% and in the unclassified group (n = 10) in 74.27%. One patient died from a mesenteric thrombosis and one from a myocardial infarction which both occurred within a few days after PTRA. Accordingly, the mortality was less than 1%.
PTRA appears to be a good treatment of renovascular hypertension caused by atherosclerosis or FMD, with good long-term antihypertensive effects.
213例高血压合并肾动脉狭窄患者接受了经皮腔内肾血管成形术(PTRA)治疗。134例患者血管造影表现为典型动脉粥样硬化,52例为纤维肌性发育异常(FMD),27例无法可靠地归为这两组中的任何一组。这些患者共治疗了272处肾动脉狭窄。其中81%的患者PTRA技术成功。这210例患者中,80%的降压效果为阳性(治愈或改善)。5年后生命表结果显示,动脉粥样硬化组(n = 35)80.27%治愈或改善,FMD组(n = 20)88.83%治愈或改善,未分类组(n = 10)74.27%治愈或改善。1例患者死于肠系膜血栓形成,1例死于心肌梗死,均发生在PTRA术后数天内。因此,死亡率低于1%。
PTRA似乎是治疗由动脉粥样硬化或FMD引起的肾血管性高血压的良好方法,具有良好的长期降压效果。