Brawn L A, Ramsay L E
University Department of Therapeutics, Royal Hallamshire Hospital, Sheffield.
Lancet. 1987 Dec 5;2(8571):1313-6. doi: 10.1016/s0140-6736(87)91203-7.
58 hypertensive patients with suspected renovascular disease underwent renal arteriography, and 29 (52%) were found to have renovascular disease. Percutaneous transluminal angioplasty was technically successful in 14 (50%) of the 29. The effect on blood pressure was assessed over 20 months. Technically successful transluminal angioplasty led to cure of hypertension in 4 patients (29%) and "improvement" in 5 (36%). However, "improvement" occurred spontaneously in 8 (32%) of the 25 patients found on arteriography not to have renovascular disease and who received no intervention. This suggests that reported improvement after transluminal angioplasty may be spurious and that the true benefit of the procedure can be assessed only from the cure rate. About 50% of patients with fibromuscular renovascular disease are cured of their hypertension but only about 8% of patients with atherosclerotic renovascular disease benefit from the procedure.
58例疑似肾血管疾病的高血压患者接受了肾动脉造影，其中29例（52%）被发现患有肾血管疾病。经皮腔内血管成形术在29例中的14例（50%）技术上成功。在20个月内评估了对血压的影响。技术上成功的腔内血管成形术使4例患者（29%）的高血压得到治愈，5例患者（36%）“病情改善”。然而，在动脉造影中发现没有肾血管疾病且未接受干预的25例患者中，有8例（32%）“病情改善”是自发出现的。这表明报道的腔内血管成形术后病情改善可能是虚假的，该手术的真正益处只能从治愈率来评估。约50%的纤维肌性肾血管疾病患者的高血压得到治愈，但只有约8%的动脉粥样硬化性肾血管疾病患者从该手术中获益。
