Tsuda Shigeyasu
Cardiology, Kitaharima Medical Center, Ono, Japan
BMJ Case Rep. 2021 May 7;14(5):e238233. doi: 10.1136/bcr-2020-238233.
A 79-year-old man developed bilateral intermittent claudication. Peritoneal dialysis had been initiated at 55 years of age to manage chronic renal failure. In addition, he underwent kidney transplantation at 61 years of age. His Ankle-Brachial Index (ABI) was 0.82 and 0.71 for the right leg and left leg, respectively. Furthermore, his serum creatinine level had increased from 0.98 mg/dL to 2.38 mg/dL over the past 2 years. CT angiography revealed focal calcified stenosis in the terminal abdominal aorta. However, ultrasound revealed no significant stenotic lesion in the supplied artery bound to the transplanted kidney from the right external iliac artery. We performed endovascular therapy for abdominal aortic stenosis using the pressure gradient. Following the procedure, the patient's symptoms disappeared and the ABI increased to 1.25 and 1.14 in the right leg and left leg, respectively. Furthermore, the serum creatinine level improved to 0.96 mg/dL.
一名79岁男性出现双侧间歇性跛行。他55岁时开始进行腹膜透析以治疗慢性肾衰竭。此外,他61岁时接受了肾移植。他的右侧和左侧下肢踝肱指数(ABI)分别为0.82和0.71。此外,在过去2年中,他的血清肌酐水平从0.98mg/dL升至2.38mg/dL。CT血管造影显示腹主动脉末端局灶性钙化狭窄。然而,超声显示从右髂外动脉到移植肾的供血动脉无明显狭窄病变。我们利用压力梯度对腹主动脉狭窄进行了血管内治疗。术后,患者症状消失,右侧和左侧下肢的ABI分别升至1.25和1.14。此外,血清肌酐水平改善至0.96mg/dL。