肾动脉狭窄支架植入后狭窄复发的自体肾移植治疗(附6例报告)

The treatment of renal artery restenosis after stent placement with kidney autotransplantation

目的 :探讨肾动脉狭窄 (RAS)经皮支架植入术后狭窄复发的治疗措施。方法 :对 6例肾动脉内支架植入后再狭窄患者行自体肾移植术治疗。结果 :随访 8～ 88个月 (平均 2 9个月 ) ,6例自体肾移植后 ,2例血压转为正常 ,4例得到改善。 3例肾功能不全中 ,1例改善 ,2例稳定。结论 :自体肾移植术对肾动脉内支架植入后狭窄复发是一种安全、有效的治疗方法 ,能明显降低血压和改善肾功能 ,可列为首选。

Objective:To assess the feasibility of kidney autotransplantation in patients with restenosis after stent placement for renal artery stenosis(RAS).Method:6 cases with restenosis were investigated. Among them, 4 cases were aortitis involving six renal arteries, 2 were atherosclerotic renal artery stenosis(ARAS)involving three renal arteries. 3 cases with insufficient renal function. The time of restenosis was from 3 to 15 months after stent placement. Kidney autotransplantation was preformed in 6 cases, one of which the nephrectomy was undertaken and contralateral kidney autotransplantation was performed half a year later.Result:The median duration of follow-up was 29 months (range 8k-88 months). Hypertension had been cured in 2 cases , improved in 4 cases. Renal function had been improved in 1 case, stabilized in 2 cases.Conclusion:The study shows that kidney autotransplantation is a safety effective remedy for restenosis of RAS.