Kuhlmann U, Grüntzig A, Vetter W, Furrer J, Lütolf U, Siegenthaler W
Schweiz Med Wochenschr. 1978 Nov 25;108(47):1847-50.
Percutaneous transluminal dilatation was performed in 5 patients with unilateral atherosclerotic renovascular disease and one patient with occlusion of a renal artery. Hemodynamic activity of the stenosis was documented by determination of pre- and poststenotic blood pressure values and by measurement of renal plasma flow. Flowing transluminal dilatation all patients showed a significant drop in blood pressure and antihypertensive treatment could be reduced or even discontinued. Only one patient became hypertensive again 3 months after the dilatation procedure. In this patient both the reduction of renal plasma flow and the delayed nephrographic effect on the stenotic side in the intravenous urogram were interpreted as symptoms of a recurrence of significant renal artery stenosis. In 2 of the six patients with impaired kidney function glomerula filtration are increased, as documented by a decrease in serum creatinine values. The results show that percutaneous transluminal dilatation may be a valuable method in the management of renovascular hypertension.
对5例单侧动脉粥样硬化性肾血管疾病患者和1例肾动脉闭塞患者进行了经皮腔内血管成形术。通过测定狭窄前后的血压值和测量肾血浆流量来记录狭窄的血流动力学情况。在所有患者进行腔内血管成形术后,血压均显著下降,抗高血压治疗可减少甚至停用。仅1例患者在扩张术后3个月再次出现高血压。在该患者中,肾血浆流量减少以及静脉肾盂造影中狭窄侧肾造影延迟效应均被解释为严重肾动脉狭窄复发的症状。6例肾功能受损患者中有2例肾小球滤过率增加,血清肌酐值下降证明了这一点。结果表明,经皮腔内血管成形术可能是治疗肾血管性高血压的一种有价值的方法。