小直径肾动脉狭窄应用西罗莫司洗脱支架的安全性和有效性

Safety and efficacy of sirolimus eluting stent in patients with small renal artery stenotic lesions

目的评估小直径肾动脉粥样硬化性狭窄患者应用冠状动脉西罗莫司洗脱支架的安全性和有效性。方法两年内入选15例患者,平均年龄67·7岁。双侧肾动脉狭窄或闭塞和单侧肾动脉狭窄各6例,副肾动脉狭窄3例。应用2种国产西罗莫司洗脱(火鸟和同心)冠状动脉支架。研究主要终点包括术后1、3和6个月靶病变直径狭窄程度(再狭窄率)和肾功能状态。结果在15例患者19处病变共成功置入22个支架,其中西罗莫司洗脱支架19个,肾动脉金属裸支架3个。全部患者完成了1个月肾动脉Doppler超声随访和血清肌酐随访,其中5例和7例分别完成了3个月和6个月的前述随访,还有3例进行了6个月血管造影随访。随访结果均未显示靶血管再狭窄,并且肾功能较术前没有明显变化。结论冠状动脉西罗莫司洗脱支架可以安全和有效应用于治疗小直径肾动脉粥样硬化性狭窄患者。

Objective To assess the safety and efficacy of sirolimus eluting stent in patients with small renal artery stenotic lesions. Methods Fifteen patients （ average age = 67.7 years old） with small renal artery stenotic lesions entered the present study during the past 2-year period, which included 6 patients with bilateral renal artery stenotic or occlusive lesions, 6 with unilateral renal artery stenosis and 3 with accessory renal artery stenosis. Two kinds of home-made coronary sirolimus eluting stent （Firebird DES stent and Partner DES stent ） were used for the study. The primary endpoint of the study was percentage of diameter stenesis in target lesion and renal function at 1, 3 and 6 months after the renal artery stenting. Results A total of 22 stents （ 19 sirolimus eluting stents and 3 renal bare metal stents） were successfitlly implanted in 19 lesions of 15 patients. Follow-up duplex ultrasound examination and serum creatinine measurement were fulfilled in all patients after 1 month, in 5 patients after 3 months and in 7 patients after 6 months after the procedure. Six-month angiographic follow-up was achieved in 3 patients. No significant restenosis in target arteries and renal functional changes were shown in follow- up studies. Conclusion Implantation of coronary sirolimus eluting stent in the patients with small renal artery stenotic lesions seems to be safe and effective.