Malina M, Brunkwall J, Ivancev K, Lindh M, Lindblad B, Risberg B
Department of Vascular and Renal Diseases, Lund University, Malmö University Hospital, Sweden.
Eur J Vasc Endovasc Surg. 1997 Aug;14(2):109-13. doi: 10.1016/s1078-5884(97)80206-7.
During the endovascular repair of abdominal aortic aneurysms (AAAs), effective anchoring of the stent-graft is difficult in the presence of a short infrarenal aneurysm neck. The aim of this study was to investigate renal artery patency and renal function after deployment of graft anchoring stents across the renal arteries.
Retrospective open study.
Twenty-five renal arteries, in 18 patients treated by endovascular exclusion of an AAA, were intentionally covered with the Gianturco Z-stent to ensure stent graft attachment.
Renal artery patency was assessed by repeated spiral computed tomography (CT) scans and angiography. Creatinine levels, blood pressure and antihypertensive medication were recorded. Follow-up was a median 6 months (2-9).
All 25 stent-covered renal arteries remained patent. CT showed a small infarct in one kidney. Creatinine was 108 mumol/l (89-133) before intervention and 98 mumol/l (87-127) at follow-up. Blood pressure was 150/80 mmHg on both occasions. Antihypertensive therapy was intensified in one patient whose creatinine level remained stable and whose separate renin sampling was normal.
Covering the renal arteries with the Gianturco Z-stent does not seem to affect renal function within 6 months. Further follow-up is needed before suprarenal stent deployment can be advocated.
在腹主动脉瘤（AAA）的血管内修复过程中，对于肾下动脉瘤颈部较短的情况，支架移植物的有效锚定较为困难。本研究的目的是调查在肾动脉上部署移植物锚定支架后肾动脉的通畅情况和肾功能。
回顾性开放性研究。
18例接受AAA血管内排除治疗的患者中的25条肾动脉，有意用Gianturco Z型支架覆盖以确保支架移植物附着。
通过重复螺旋计算机断层扫描（CT）和血管造影评估肾动脉通畅情况。记录肌酐水平、血压和抗高血压药物使用情况。随访时间中位数为6个月（2 - 9个月）。
所有25条被支架覆盖的肾动脉均保持通畅。CT显示一个肾脏有小梗死灶。干预前肌酐为108μmol/L（89 - 133），随访时为98μmol/L（87 - 127）。两次测量血压均为150/80 mmHg。一名肌酐水平保持稳定且单独肾素采样正常的患者强化了抗高血压治疗。
在6个月内用Gianturco Z型支架覆盖肾动脉似乎不会影响肾功能。在提倡肾上支架部署之前，需要进一步随访。
