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[CORAL试验后时代的肾动脉介入治疗——过时了还是有时仍合理?]

[Renal artery intervention in the post-CORAL era - obsolete or sometimes reasonable?].

作者信息

Vischer Annina, Seiler Karin, Uthoff Heiko, Burkard Thilo

机构信息

Kardiologie, Universitätsspital Basel.

Medizinische Poliklinik, Universitätsspital Basel.

出版信息

Dtsch Med Wochenschr. 2015 Sep;140(18):1372-5. doi: 10.1055/s-0041-103629. Epub 2015 Sep 11.

Abstract

Significant renal artery stenosis may cause both secondary therapy-resistant arterial hypertension and renal failure. We report the case of a 74-year old man with an occlusion of the right renal artery and a stenosis of the left renal artery causing right sided renal atrophy, renal failure and resistant arterial hypertension. Revascularization with percutaneous renal angioplasty (PTRA)/stenting of the left renal artery helped to improve both kidney function and hypertension control. Interestingly, the patient would not have qualified for any of the recent randomized outcome trials. Therefore, renal artery intervention remains a reasonable option in highly and interdisciplinarily selected patients, despite the more conservative treatment approach after the recent trials.

摘要

严重的肾动脉狭窄可能导致继发性难治性动脉高血压和肾衰竭。我们报告了一例74岁男性患者,其右肾动脉闭塞,左肾动脉狭窄,导致右侧肾萎缩、肾衰竭和难治性动脉高血压。经皮肾血管成形术(PTRA)/左肾动脉支架置入术进行血运重建有助于改善肾功能和控制高血压。有趣的是,该患者不符合最近任何一项随机试验的入选标准。因此,尽管最近的试验后治疗方法更为保守,但对于经过高度和多学科筛选的患者,肾动脉介入治疗仍然是一个合理的选择。

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