经皮腔内肾动脉成形及支架置入术治疗老年冠心病合并肾动脉狭窄23例临床分析

Percutaneous transluminal renal arterioplasty and stent implantation for aged patients complicated with coronary artery disease and renal artery stenosis

目的观察经皮腔内肾动脉成形及支架置入术治疗冠心病合并肾动脉狭窄患者的临床效果。方法对23例冠心病合并动脉粥样硬化性肾动脉狭窄的老年患者行经皮腔内肾动脉成形术并置入支架,观察术后临床和血管造影随访结果。结果23例老年患者的31支严重狭窄的肾动脉行肾动脉成形及支架置入术,技术成功率100%;平均临床随访11个月,患者血压得到明显控制,总有效率为87.0%;71.0%的患者肾功能得到明显改善;17例患者的18支血管于术后6个月血管造影随访,16支血管无再狭窄。结论对冠心病合并动脉粥样硬化性肾动脉狭窄的老年患者,采用经皮腔内肾动脉成形及支架置入术治疗是安全有效的。

Objective To evaluate the clinical efficacy of percutaneous transluminal renal angioplasty （PTRA） and stent implantation in treatment of patients with coronary artery disease complicated with atherosclerotic renal artery stenosis. Methods Twenty three aged patients with coronary artery disease and atherosclerotic renal artery stenosis were treated with PTRA and stent implantation, clinical and angiographic assessment during 12 and 6 month follow-up was done regularly. Results Procedure success rate in 31 vessels of 23 patients was 100%. The blood pressure control improved in 87.0% of the patients and renal function improved in 71.0% of the patients during a mean clinical follow-up of 11 months. Angiographic follow up was done in 17 patients with 18 vessels at 6 months after operation. Sixteen of the operated vessels had no restenosis. Conclusion PTRA in old patients with coronary heart disease and atherusclerotic renal artery stenusis has a high success and effective rate.