Türler A, Walter M, Landwehr P, Erasmi H
Klinik und Poliklinik für Chirurgie, Universität zu Köln.
Vasa. 1996;25(4):368-72.
Vasculopathy is a rare and undervalued complication in neurofibromatosis. Histopathological changes of the vascular wall may lead to relevant renal artery stenosis. We report a case of a 17-year-old patient with neurofibromatosis and severe renovascular hypertension resulting from a proximal renal artery stenosis. Attempted percutaneous renal angioplasty was unsuccessful and the patient was referred for operative revascularization. After insertion of an aortorenal bypass with a reversed saphenous vein graft the patient became normotensive without medication. Based on our own experience and a review of the literature we recommend operative reconstruction of stenotic renal arteries in neurofibromatosis.
血管病变是神经纤维瘤病中一种罕见且未得到充分重视的并发症。血管壁的组织病理学改变可能导致相关的肾动脉狭窄。我们报告一例17岁患有神经纤维瘤病的患者,其因近端肾动脉狭窄导致严重的肾血管性高血压。经皮肾血管成形术尝试失败,该患者被转诊进行手术血运重建。在植入一段倒置大隐静脉移植的主动脉-肾动脉旁路后,患者无需药物治疗血压即恢复正常。基于我们自己的经验及文献回顾,我们建议对神经纤维瘤病患者的狭窄肾动脉进行手术重建。