Mahler F, Triller J, Weidmann P, Nachbur B
Nephron. 1986;44 Suppl 1:60-3. doi: 10.1159/000184049.
We propose a classification of the complications in renal artery percutaneous transluminal angioplasty (PTA) according to their severity and their direct or indirect relationship to PTA. Minor complications are reversible within the normal recovery period after PTA, while major complications are irreversible or reversible but necessitate extended hospitalization or surgery. The following complications are reported in the literature as being directly related to PTA: hemorrhage at the puncture site, hemorrhage from renal or access artery perforation or rupture, occlusive or nonocclusive dissection of the renal or access arteries, renal artery thrombosis, renal artery spasm or embolism leading to segmental renal infarction, peripheral artery embolisation, and balloon rupture complications. The indirectly related complications include transient or irreversible renal insufficiency, contrast media hypersensitivity, pressure-drop-related cerebral or myocardial ischemia, and anticoagulation-related hemorrhage infections. In our own series of 105 PTA in 80 patients, complications occurred in 11% of which 4% were major, 1% indirectly related to PTA leading to death. In the reports available, the rate of major complication ranges between 3 and 10%, and the death rate around 1%.
我们根据肾动脉经皮腔内血管成形术（PTA）并发症的严重程度及其与PTA的直接或间接关系对其进行分类。轻微并发症在PTA后的正常恢复期内可逆转，而严重并发症则不可逆转或虽可逆转但需要延长住院时间或进行手术。文献报道的与PTA直接相关的并发症如下：穿刺部位出血、肾动脉或入路动脉穿孔或破裂出血、肾动脉或入路动脉的闭塞性或非闭塞性夹层、肾动脉血栓形成、导致节段性肾梗死的肾动脉痉挛或栓塞、外周动脉栓塞以及球囊破裂并发症。间接相关并发症包括短暂性或不可逆性肾功能不全、造影剂过敏、与压力下降相关的脑或心肌缺血以及与抗凝相关的出血感染。在我们自己的系列研究中，80例患者接受了105次PTA，并发症发生率为11%，其中4%为严重并发症，1%与PTA间接相关并导致死亡。在现有报告中，严重并发症发生率在3%至10%之间，死亡率约为1%。
