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复杂血管内主动脉手术中肾动脉桥接支架植入对肾阻力指数的影响。

Influence of Bridging Stent Graft Implantation into the Renal Artery during Complex Endovascular Aortic Procedures on the Renal Resistance Index.

作者信息

Reitnauer Daniela, Stoklasa Kerstin, Dueppers Philip, Reutersberg Benedikt, Zimmermann Alexander, Stadlbauer Thomas H W

机构信息

Department of Vascular Surgery, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.

Department of Vascular Surgery, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.

出版信息

Diagnostics (Basel). 2024 Aug 26;14(17):1860. doi: 10.3390/diagnostics14171860.

Abstract

Comparative sonographic examination of the renal resistance index (RRI) can provide evidence of renal artery stenosis. The extent to which the RRI is changed after stent graft implantation is not known. The aim of this study was to investigate the influence of stent graft implantation into non-diseased renal arteries during endovascular treatment of pararenal aortic aneurysms on the RRI. Sonographic examinations of the kidneys were conducted using a GE ultrasound system. The evaluation was performed according to the European Society for Vascular Surgery (ESVS) 2D standard criteria. RRI values were determined in consecutive patients on the day before and after stent graft implantation and compared for each kidney. A total of 32 consecutive patients (73.9 ± 8.2 years, 5 females, 27 males) were treated with a fenestrated or branched aortic stent graft including bridging stent graft implantations into both renal arteries and received pre- and postinterventional examinations. Sonomorphologically, the examined kidneys were inconspicuous. The arborisation of the renal perfusion was preserved pre- and post-implantation. The RRI did not differ (0.66 ± 0.06 versus 0.67 ± 0.07; = ns). Successful stent graft implantation into non-stenosed renal arteries did not lead to a relevant change in RRI. Therefore, the RRI is a suitable tool for assessing renal perfusion after fenestrated or branched endovascular aortic therapy.

摘要

对肾阻力指数(RRI)进行超声对比检查可提供肾动脉狭窄的证据。目前尚不清楚支架移植物植入后RRI的变化程度。本研究的目的是探讨在肾旁主动脉瘤血管内治疗期间将支架移植物植入无病变肾动脉对RRI的影响。使用GE超声系统对肾脏进行超声检查。根据欧洲血管外科学会(ESVS)的二维标准标准进行评估。在支架移植物植入前一天和植入后,对连续患者的RRI值进行测定,并对每个肾脏进行比较。共有32例连续患者(73.9±8.2岁,女性5例,男性27例)接受了开窗或分支主动脉支架移植物治疗,包括将桥接支架移植物植入双侧肾动脉,并接受了介入前后检查。在超声形态学上,所检查的肾脏无明显异常。植入前后肾灌注的分支情况均得以保留。RRI无差异(0.66±0.06对0.67±0.07;P=无显著性差异)。成功地将支架移植物植入无狭窄的肾动脉并未导致RRI发生相关变化。因此,RRI是评估开窗或分支血管内主动脉治疗后肾灌注的合适工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b6f/11394166/66fdbc7ed7da/diagnostics-14-01860-g001.jpg

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