巧克力球囊扩张术在动脉粥样硬化型肾动脉狭窄治疗中的疗效及安全性

Effect and safety of chocolate balloon dilatation in the treatment of atherosclerotic renal artery stenosis

目的探讨巧克力球囊扩张术在动脉粥样硬化型肾动脉狭窄(ARAS)治疗中的疗效及安全性。方法收集2018年6月至2020年8月郑州大学第五附属医院收治的19例ARAS患者的临床资料,均应用巧克力球囊行腔内血管成形术,术后随访6个月,分析巧克力球囊扩张术在ARAS治疗中的疗效及安全性。结果19例患者均成功重建狭窄肾动脉血管,手术成功率100%。术后随访,17例(89.47%)患者血压可稳定在140/90 mmHg(1 mmHg=0.133 kPa)以下,2例患者血压控制不佳,术后服用降压药物减少1种以上16例(84.21%),1例(5.26%)出现缺血性脑病,1例(5.26%)发生再狭窄。结论巧克力球囊扩张术治疗ARAS疗效显著,可有效改善患者的顽固性高血压等问题,降低夹层形成率,安全性较好,具有较高的临床应用价值。

Objective To investigate the efficacy and safety of chocolate balloon dilatation in the treatment of atherosclerotic renal artery stenosis(ARAS).Method The clinical data of 19 patients with ARAS who were admitted to the Fifth Affiliated Hospital of Zhengzhou University from June 2018 to August 2020 were collected and treated with chocolate balloons for endovascular angioplasty.The postoperative follow-up 6 months,the effect and safety of chocolate balloons in the treatment of ARAS were also analyzed.Result Renal artery reconstruction was successful in all 19 cases,the success rate of the surgery was 100%.During postoperative follow-up,the blood pressure of 17 patients(89.47%)could be stabilized below 140/90 mmHg(1 mmHg=0.133 kPa),2 patients had poor blood pressure control,and postoperative antihypertensive drugs were reduced by more than 1 in 16 patients(84.21%),1 patient(5.26%)developed ischemic encephalopathy,and 1 patient(5.26%)developed restenosis.Conclusion The employment of chocolate balloon dilatation has a remarkable curative effect in treating ARAS,and could effectively improve the patient’s refractory hypertension and other problems.The therapy could also reduce the formation rate of dissection with good safety and high clinical application value.