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慢性肾动脉闭塞的成功血管内治疗:一项纳入15例患者的初步回顾性病例系列研究。

Successful endovascular treatment of chronic renal artery occlusion: a preliminary retrospective case series including 15 patients.

作者信息

Yang Min, Lin Letao, Niu Guochen, Yan Ziguang, Zhang Bihui, Tong Xiaoqiang, Zou Yinghua

机构信息

Department of Interventional Radiology and Vascular Surgery, Peking University First Hospital, 8 Xishiku St, Beijing, 100034, People's Republic of China.

出版信息

Int Urol Nephrol. 2019 Feb;51(2):285-291. doi: 10.1007/s11255-018-02067-0. Epub 2019 Jan 3.

Abstract

PURPOSE

To evaluate in a retrospective, single-center, case series if percutaneous transluminal renal angioplasty/stenting of chronic renal artery occlusion is beneficial to renal function and blood pressure control, which remains controversial.

METHODS

Data from 15 consecutive patients with renal artery stump who underwent successful percutaneous transluminal renal angioplasty/stenting only for unilateral chronic renal artery occlusion at our center from January 2007 to February 2018 and completed follow-up were retrospectively evaluated. Of the 15 patients, 14 (93.3%) were treated with stenting and 1 with only balloon angioplasty. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula corrected for Chinese, and changes in blood pressure and need for antihypertensive medications were recorded.

RESULTS

At median 1.5-year (interquartile range 0.5-5.0) follow-up, restenosis rate was 20.0%. Renal function improved or remained stable in 26.7% and 53.3% of patients, respectively, and blood pressure normalized or improved in 13.3% and 40.0% of patients, respectively. Young patients with Takayasu's arteritis or fibromuscular dysplasia appeared to benefit the most from revascularization.

CONCLUSIONS

In this preliminary retrospective series of select patients with renal artery stump, endovascular treatment of chronic renal artery occlusion appeared to preserve renal function and improve blood pressure.

摘要

目的

在一项回顾性、单中心病例系列研究中,评估经皮腔内肾血管成形术/支架置入术治疗慢性肾动脉闭塞对肾功能和血压控制是否有益,这一问题仍存在争议。

方法

回顾性评估2007年1月至2018年2月在本中心连续15例仅因单侧慢性肾动脉闭塞而成功接受经皮腔内肾血管成形术/支架置入术且完成随访的肾动脉残端患者的数据。15例患者中,14例(93.3%)接受了支架置入术,1例仅接受了球囊血管成形术。使用校正后的中国肾脏病饮食改良(MDRD)公式计算估算肾小球滤过率(eGFR),记录血压变化和降压药物需求。

结果

在中位1.5年(四分位间距0.5 - 5.0年)的随访中,再狭窄率为20.0%。肾功能改善或保持稳定的患者分别占26.7%和53.3%,血压正常化或改善的患者分别占13.3%和40.0%。患有高安动脉炎或纤维肌发育不良的年轻患者似乎从血运重建中获益最大。

结论

在这个初步的回顾性系列选择的肾动脉残端患者中,慢性肾动脉闭塞的血管内治疗似乎能保留肾功能并改善血压。

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