移植肾动脉狭窄的影像诊断与介入治疗

Imaging Diagnosis and Interventional Therapy of Transplant Renal Artery Stenosis

目的探讨移植肾动脉狭窄影像诊断与介入治疗的方法及疗效。方法经彩色多普勒超声筛查并经动脉造影证实为移植肾动脉狭窄的患者24例,19例行单纯球囊扩张术,3例同期行球囊扩张加支架植入,2例球囊成形术后复发狭窄患者再次接受了支架植入术。结果所有患者治疗均取得成功,技术成功率为100%,未发生严重并发症。治疗后近期疗效较好,所有患者的血压和肌酐均较术前明显下降(P<0.01),2例再狭窄者行支架植入术后肾功能亦明显改善。结论彩色多普勒超声可用于移植肾动脉狭窄的筛查和治疗后随访,移植肾动脉造影是诊断的金标准,介入治疗为有效治疗方法。

Objective To discuss the diagnostic methods of transplant renal artery stenosis?(TRAS?)and clinical outcome following percutaneous transluminal angioplasty. Methods Of 24 patients with TRAS screened by color Doppler ultrasound and confirmed with digital subtraction angiography? balloon angioplasty was performed in 19 patients? and 5 patients received stent implantation? including 2 cases of recurrent stenosis. Results Technical success was achieved in all procedures with no serious complications. The blood pressure and serum creatinine levels of all patients were remarkably decreased?(P < 0.01?). Renal functions of the two patients with restenosis were significantly improved after intra-arterial stenting. Conclusions Doppler ultrasonography is useful in the screening and follow-up of TRAS and arteriography is still the definite diagnostic method. Percutaneous transluminal angioplasty and stenting are safe and effective procedures to treat TRAS.