Kuhlmann U, Greminger P, Grüntzig A, Schneider E, Pouliadis G, Lüscher T, Steurer J, Siegenthaler W, Vetter W
Am J Med. 1985 Dec;79(6):692-8. doi: 10.1016/0002-9343(85)90519-4.
Percutaneous transluminal dilatation was attempted in 65 patients with renovascular hypertension. In five cases (8 percent), percutaneous transluminal dilatation could not be performed for technical reasons. In the remaining 60 patients (35 with atherosclerotic stenosis and 25 with fibromuscular dysplasia), both mean systolic and diastolic pressure fell immediately after percutaneous transluminal dilatation and remained significantly lower for a period of up to five years. Cure rates after a mean control period of 21.6 months were higher in patients with fibromuscular dysplasia (50 percent) than in those with atherosclerotic stenosis (29 percent). Improvement of blood pressure was observed in 32 percent of patients with fibromuscular dysplasia and in 48 percent of patients with atherosclerotic stenosis. Follow-up angiography in 33 cases showed occlusion of the dilated artery in two patients and recurrence of slight renal artery stenosis in nine patients. Successful redilatation could be performed in five of these cases. Furthermore, renal vein renin determinations were only of limited diagnostic or prognostic value. These results document the good long-term effect of percutaneous transluminal dilatation in patients with renal artery stenosis. Percutaneous transluminal dilatation should, therefore, be the favored procedure in patients with renovascular hypertension.
对65例肾血管性高血压患者尝试进行经皮腔内扩张术。5例（8%）因技术原因无法进行经皮腔内扩张术。其余60例患者（35例为动脉粥样硬化性狭窄，25例为纤维肌性发育异常），经皮腔内扩张术后收缩压和舒张压均立即下降，且在长达5年的时间里显著低于术前。平均对照期21.6个月后，纤维肌性发育异常患者的治愈率（50%）高于动脉粥样硬化性狭窄患者（29%）。纤维肌性发育异常患者中有32%血压改善，动脉粥样硬化性狭窄患者中有48%血压改善。33例患者的随访血管造影显示，2例患者扩张动脉闭塞，9例患者肾动脉轻度狭窄复发。其中5例患者成功进行了再次扩张。此外，肾静脉肾素测定的诊断或预后价值有限。这些结果证明经皮腔内扩张术对肾动脉狭窄患者具有良好的长期疗效。因此，经皮腔内扩张术应成为肾血管性高血压患者的首选治疗方法。
