移植肾动脉狭窄的经皮血管成形术

Percutaneous Transluminal Angioplasty of Transplanted Renal Artery Stenosis

目的：探讨移植肾动脉狭窄（ＴＲＡＳ）的经皮血管成形术（ＰＴＡ）。材料和方法：经对侧股动脉或左肱动脉入路，使用５Ｆ普通球囊导管和２．６Ｆ微球囊导管，分别对８例ＴＲＡＳ行ＰＴＡ术。结果：经股动脉行ＰＴＡ成功４例，另４例改由肱动脉入路获成功。其中，４例行普通球囊导管扩张，另４例采用微球囊导管扩张或预扩后行普通球囊导管扩张。肾动脉狭窄率由治疗前的８４％—９７％降至１２％—３０％。无并发症。术后疗效：显效率６２．５％（５／８），有效率８７．５％（７／８）。结论：ＰＴＡ可安全有效地治疗ＴＲＡＳ。经肱动脉入路和微球囊导管的使用有助于提高手术成功率。

urpose:To analyze the management of transplanted renal artery stenosis(TRAS) by percutaneous trasluminal angioplasty(PTA).Materials and Methods:PTA was performed in 8 cases of TRAS through femoral orbrachial approach with 5F or 2.6F balloon catheters. Results: In 4 cases,PTA were successful by femoral approach,but failed in other cases,furthermore were successful by brachial approach. In 4 cases,dilations were carried out with 5F balloon catheter,the other 4 cases with 2.6F balloon catheter only or followed by 5F balloon catheter.Stenosis were sigificantly decreased from 84% to 97%pre-PTA to 12%-30% post-PTA. No complications happened.Clinical outcomes showed significant successful rate was 62.5%(5/8), total successful rate was 87.5%(7/8). Conclusion:PTA is a safe and effective means of management for TRAS. Brachial approach and small balloon catheter may improve the rate success.