Treatment of renal artery fibromuscular dysplasia with balloon angioplasty: a prospective follow-up study
Treatment of renal artery fibromuscular dysplasia with balloon angioplasty: a prospective follow-up study
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DOI：
10.1053/ejvs.2001.1559
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发表时间：
2002-02-01
影响因子：
5.7
通讯作者：
Baumgartner, I
中科院分区：
文献类型：
--
作者：
Birrer, M;Do, DD;Baumgartner, I
目的：评估纤维肌性发育不良性肾动脉狭窄患者经皮腔内肾血管成形术（PTRA）后的再狭窄率和血压反应。方法：对27例31例接受治疗的肾动脉狭窄患者进行前瞻性12个月随访研究。随访评估包括出院前和3、6和12个月时的肾动脉彩色编码双功超声（CCD）、血压监测、抗高血压药物和肌酐测量。主要终点定义为血流动力学显著再狭窄>60%，12个月时累积再狭窄率为23%。93%的患者在干预后立即治愈或改善动脉高血压，并在12个月随访时74%的患者保持治愈/改善。肾功能衰竭存在于PTRA前5例稳定或改善所有patients.Conclusions：虽然PTRA后再狭窄率在纤维肌性发育不良是一样高，在非开口动脉粥样硬化病变，仍然有相当高的治疗效果。与动脉粥样硬化性肾动脉病变患者相比，严重的压力反应和复发性动脉高血压伴再狭窄支持了这一年轻健康人群中动脉高血压肾血管起源的高概率。
Objectives: to assess restenosis rates and blood pressure response after percutaneous transluminal renal angioplasty (PTRA) in patients treated for fibromuscular dysplastic renal artery stenosis.Methods: a prospective 12-month follow-up study of 27 patients with 31 treated renal artery stenosis. Follow-up assessment included colour-coded duplex sonography (CCD) of renal arteries, monitoring of blood pressure, antihypertensive medication, and creatinine measurements before discharge and at 3, 6, and 12 months. Primary end point was defined as a haemodynamically significant restenosis >60% assessed by CCD.Results: there was a cumulative 23% restenosis rate at 12 months. Arterial hypertension was cured or improved in 93% of patients immediately after the intervention and remained cured/improved in 74% of patients at 12 months of follow-up. Renal failure present in five patients before PTRA stabilised or improved in all patients.Conclusions: although restenosis rate after PTRA in fibromuscular dysplasia is as high as in non-ostial atherosclerotic lesions, there remains a considerable higher therapeutic effect. Profound pressure response and recurrent arterial hypertension with restenosis support the high probability of a renovascular origin of arterial hypertension in this young and otherwise healthy population compared to patients with atherosclerotic renal artery lesions.