肾动脉狭窄并顽固性高血压支架置入术探讨

Clinical Observation of Angioplasty and Stenting in Elderly Patients with Refractory Hypertension Caused by Renal Artery Stenosis

目的评价经皮肾动脉腔内成形及支架置入术(Percutaneous translum ina renal angiop lasty and stentp lacem ent,PTRAS)治疗老年肾动脉狭窄并顽固性高血压患者的疗效及安全性。方法23例选择性肾动脉造影确诊的肾动脉狭窄患者,行经皮肾动脉腔内成形术(PTRA)及PTRAS,观察术前、术后血管直径、血压、肾功能的变化及术中、术后并发症情况,并进行6个月随访。结果共完成23例患者27条肾动脉PTRAS,操作成功率100%,血管直径由术前平均(1.8±0.9)mm增加到(5.3±1.6)mm,术后患者的血压易于控制,肾功能得到改善,围手术期及随访6个月无并发症及死亡。结论PTRAS是治疗老年人肾动脉狭窄并顽固性高血压的安全、有效方法。

Objective To evaluate the therapeutic effect and safety of percutaneous transluminal renal angioplasty（PTRA） and stent （PTRAS）for renal artery stenosis in the aged. Methods All 23 aged patients were diagnosed as atherosclerotie renal disease by reual angiography and underwent simultaneous or selective PTRAS. The blood pressure level, prescription of pressure - lowering drugs and the serum creatine level before and after the operation were analyzed. Change in vessel diameter and perioperative complications were recorded, and followed - up for 6 months. Results Anglographic success was obtained in 27 renal artery of 23 patients after PTRAS,an interventional procedure rate of 100% was achived. The mean luman diameter increased from（ 1.8 ± 0. 9）mm to（5.3± 1. 6） mm. Tile renal function was improved in 4 cases with impaired renal function before operation, The blood pressure level decreased or returned to normal level after PTRAS. There were uo postoperative complication recorded after 6month followup, Conclusion PTRAS is efteetive and safe in treating refractory hypertension caused by renal artiery stenosis in the aged.