纤维肌发育不良区域的体内血管内超声成像及血管内压力梯度引导下的经皮腔内肾血管成形术。
In vivo intravascular ultrasound imaging of fibromuscular dysplastic region and intravascular pressure gradient-guided percutaneous transluminal renal angioplasty.
作者信息
Onoue Yoshiro, Tsujita Kenichi, Hokimoto Seiji, Kaikita Koichi, Sugiyama Seigo, Ogawa Hisao
机构信息
Department of Cardiovascular Medicine, Faculty of Life Sciences, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
出版信息
J Cardiol Cases. 2011 Sep 15;4(3):e163-e167. doi: 10.1016/j.jccase.2011.08.006. eCollection 2011 Dec.
Fibromuscular dysplasia (FMD) is one of the etiologies of renal artery stenosis (RAS) and secondary hypertension. Balloon angioplasty has emerged as the mainstay of treatment because patients with FMD usually show substantial clinical and anatomic response to renal angioplasty without stenting. We report a 21-year-old male case of FMD-induced RAS treated with intravascular ultrasound- and pressure gradient-guided renal angioplasty. Ultrasonic imaging of the stenotic renal artery clearly visualized adventitial fibrotic band surrounding the negative remodeled renal artery and the accompanying atherosclerotic plaque. The findings suggest that atherosclerotic change can occur in young patients with renal FMD that is basically considered to be nonatherosclerotic. Pressure gradient measurement is also useful in confirming hemodynamic improvement during angioplasty.
纤维肌性发育不良（FMD）是肾动脉狭窄（RAS）和继发性高血压的病因之一。球囊血管成形术已成为主要的治疗方法，因为FMD患者通常对无支架的肾血管成形术表现出显著的临床和解剖学反应。我们报告一例21岁男性FMD所致RAS患者，采用血管内超声和压力梯度引导下的肾血管成形术进行治疗。狭窄肾动脉的超声成像清晰显示了围绕负性重塑肾动脉的外膜纤维化带以及伴随的动脉粥样硬化斑块。这些发现表明，在基本被认为是非动脉粥样硬化性的肾FMD年轻患者中也可能发生动脉粥样硬化改变。压力梯度测量在确认血管成形术期间血流动力学改善方面也很有用。
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