大动脉炎性肾动脉狭窄支架植入术的疗效分析

Interventional Therapy Using Intraluminal Stent Implantation for Renal Vascular Hypertension of Takayasu Arteritis

目的研究经皮腔内血管成形术+内支架植入术治疗大动脉炎性肾动脉狭窄所致肾性高血压的临床效果。资料与方法选用Palmaz支架和AVEBridge支架,对18例大动脉炎所致肾动脉狭窄先行经皮腔内肾动脉成形术(PTRA),然后放置支架。术后检测血管的内径和术后一周时血压的变化。结果18例PTRA+支架植入术技术成功率100%。血管内径由术前平均为(1.7±0.6)mm恢复至术后为(5.3±0.4)mm,术后1周时血压由术前的(22.7±3.3/14.0±2.1)kPa降为(19.3±1.6/10.4±2.0)kPa,其中10例血压恢复正常,6例血压改善。术后随访肾动脉血流通畅,血压控制满意。结论PTRA+支架植入术治疗大动脉炎性肾动脉狭效果满意,创伤小,患者痛苦少;PTRA+支架术是目前治疗大动脉炎性肾动脉狭窄的首选方法,具有安全、简便、有效的优点。

Objective To study the clinical efficacy of percutaneous transluminal renal angioplasty (PTRA) and intraluminal stent implantation for patients with renal vascular hypertension of Takayasu arteritis.Materials and Methods 18 patients (4 males and 14 females) with renal stenosis of Takayasu arteritis were performed with PTRA at first, and then stent (with Palmaz and AVE Bridge) was implanted to the renal arteries. Changes in vessel diameter and blood pressure in a week before and after were observed.Results 19 stents were successfully implanted in 18 cases. The mean diameter of lesion increased from (1.7±0.6)mm to (5.3±0.4)mm, blood pressure decreased from (22.7±3.3/14.0±2.1)kPa to (19.3±1.6/10.4±2.0)kPa in a week, blood pressure in 10 of 18 patients become normal without taking any antihypertensive medication and blood pressure control was more facile in 6 patients. However, there was no improvement in 2 patients. No recurrence of Hypertension was found follow up from 3 to 36 months.Conclusion PTRA with stent placement is a good method to treat renal vascular hypertension of Takayasu arteritis, and it is satisfactory with minimal invasive, less pain, feasible and safty.