Simonetti G, Bonomo L, Cornalba G P, De Caro G, Falappa P, Feltrin G, Gandini G, Grosso M, Iaccarino V, Lupattelli L
Istituto di Radiologia, Università di Roma Tor Vergata, Ospedale S. Eugenio.
Radiol Med. 1993 Oct;86(4):503-8.
The data relative to 13 years' experience with percutaneous transluminal renal angioplasty (PTRA) in the 13 major interventional radiology centers in Italy were collected and analyzed to evaluate technical and clinical results. Our aim was to collect homogeneous results in a large series of patients, evaluating both the technical and the clinical success with a long-term follow-up (1 month-13 years). One thousand three hundred forty seven PTRA procedures (including 42 restenoses) in 1,073 patients were retrospectively reviewed. In 807 cases the cause of stenosis was atherosclerosis, in 442 cases fibromuscular dysplasia and in 24 cases arteritis in 12 cases, stenoses were present in patients that had undergone a surgical by-pass. Sixty-two stenoses in patients with solitary kidney and 102 in patients with renal failure were studied separately. The technical success (based on the morphology of the dilated tract) obtained in 91% of cases was considered, together with the clinical success (in 81% of cases), based on the decrease in blood pressure evaluated according to Martin's classification. The blood pressure values collected after the maneuver were also evaluated separately for the different types of stenosis etiology: atherosclerosis, fibromuscular dysplasia or arteritis; moreover, blood pressure was studied in solitary kidney patients and in those with renal failure. Complications were classified as major (4.2%) and minor (4.9%). The high success rate and the low incidence of complications we observed in our series suggest PTRA as the procedure of choice for high blood pressure patients with renal artery stenosis > 50% of the normal caliber.
收集并分析了意大利13家主要介入放射学中心13年经皮腔内肾血管成形术（PTRA）的相关数据，以评估技术和临床结果。我们的目的是在大量患者中收集同类结果，通过长期随访（1个月至13年）评估技术和临床成功率。对1073例患者的1347例PTRA手术（包括42例再狭窄）进行了回顾性研究。807例狭窄病因是动脉粥样硬化，442例是纤维肌发育异常，24例是动脉炎，12例狭窄患者曾接受过外科搭桥手术。对孤立肾患者的62例狭窄和肾衰竭患者的102例狭窄进行了单独研究。根据扩张通道的形态学，91%的病例获得了技术成功，同时根据马丁分类法评估的血压下降情况，81%的病例获得了临床成功。还针对不同类型的狭窄病因（动脉粥样硬化、纤维肌发育异常或动脉炎）分别评估了术后收集的血压值；此外，还对孤立肾患者和肾衰竭患者的血压进行了研究。并发症分为严重（4.2%）和轻微（4.9%）。我们在本系列中观察到的高成功率和低并发症发生率表明，PTRA是肾动脉狭窄超过正常管径50%的高血压患者的首选治疗方法。
