Hau T
Department für Allgemeinchirurgie, St.-Willehad-Hospitals Wilhelmshaven.
Zentralbl Chir. 1988;113(16):1024-34.
Fibromuscular dysplasia of the renal artery can be treated by vascular surgical reconstruction or percutaneous transluminal angioplasty. If, however, the secondary and tertiary branches of the renal artery are involved, this lesion cannot be corrected with conventional surgical techniques or invasive radiologic methods. Because the disease often affects young patients, in whom an etiologic treatment of the hypertension is desirable, we have performed ex vivo repair of lesions of the renal artery and its branches with autotransplantation of the kidney in five patients. Four patients had renovascular hypertension and one patient an aneurysm of a tertiary branch of the renal artery. Postoperatively, renal function, as evidenced by renal scan and renal function studies, was normal in all autotransplanted kidneys. All four patients with renovascular hypertension had normal blood pressure postoperatively. Only one patient had to be treated with single drug antihypertensive therapy.
肾动脉纤维肌性发育异常可通过血管外科重建术或经皮腔内血管成形术进行治疗。然而,如果肾动脉的二级和三级分支受累,这种病变无法用传统外科技术或侵入性放射学方法矫正。由于该疾病常累及年轻患者,而这些患者需要对高血压进行病因治疗,我们对5例患者进行了肾动脉及其分支病变的体外修复并自体肾移植。4例患者患有肾血管性高血压,1例患者患有肾动脉三级分支动脉瘤。术后,通过肾扫描和肾功能研究证明,所有自体移植肾的肾功能均正常。所有4例肾血管性高血压患者术后血压均正常。只有1例患者需要接受单一药物降压治疗。