移植肾动脉狭窄:血管成形术径路和方法  

Transplant Renal Arterial Stenosis:Approach and Methods of Percutaneous Transluminal Angioplasty

作　　者：刘鹏程[1] Otal Philippe Colombier Daniel Rousseau Herve Cisterne Jean-Marc FrancisJoffre 

机构地区：[1]同济医科大学附属同济医院放射科 [2]Service de Radiologie,H■pital de Rangueil, CHRU de Toulouse,France [3]Service de Nephrologie,H■pital de Rangueil,CHRU de Toulouse,France

出　　处：《放射学实践》1998年第3期93-97,共5页Radiologic Practice

摘　　要：目的用于评价两种径路的血管成形术的方法对移植肾动脉狭窄的治疗作用。材料与方法 18例移植肾动脉狭窄并高血压患者成功进行了血管成形术。18例中,15例患者血管狭窄位于外科手术血管吻合处或吻合处远侧端移植肾动脉主干,3例位于移植肾的肾内分支动脉。同侧股动脉径路用于治疗端-侧血管吻合的患者(n=10),对侧股动脉径路,用于治疗端-端血管吻合的患者(n=6)。16例采用股动脉径路,2例经肱动脉径路。疗效以临床随访、血管造影和超声追踪为评价。结果 18例移植肾动脉狭窄患者成功地施行了血管成形术。成形术后,所有病人均治愈。1例患者因为复发动脉狭窄,而再次作血管扩张,同时放置1个支撑器。第二次血管成形术后6个月,考虑病人已治愈。结论血管成形术是移植肾动脉狭窄所致长期高血压和肾功能减退的有效的、首选治疗方法。Purpose To evaluate primary success and patency of Percutaneous Transluminal Angioplas- ty(FTA)for the treatment of renal transplant arterial stenosis.Material and methods FTA was attempted in 18 hypertensive patients with transplant renal artery stenosis.15 patients had a stenosis of the surgical anastomo- sis or the main renal artery distal to the anastomosis and 3 had a stenosis of a renal artery branch.We selected the ipsilateral approach for end-to-side anastomosis with the external iliac artery(n=10)and the contralateral approach for end-to-end anastomosis with the hypogastric artery(n=6).The femoral approach was used in 16 and brachial artery was in 2.Results at clinical,angiographic and ultrasound follow-up were assessed.Results An Interventional procedure was successful in 18 patients having transplant renal arterial stenosis.Immediately after FTA,all patients were cured.One patient was associated with clinical relapse;the artery was redilated,and a stent was given in this patient who was considered cured at the second 6-month follow-up.Conclusion PTA is an effective method for treatment of long term hypertension and deterioration of renal function due to stenoses of renal transplant arteries.It should be considered as a first-line treatment for transplant renal arterial stenosis.

关 键 词：肾移植 动脉狭窄 血管成形术 移植肾 

分 类 号：R699.2[医药卫生—泌尿科学] R654.3[医药卫生—外科学]