- 期刊
Effects of Renal Artery Stenting on Renal Function and Blood Pressure in a Patient with Atherosclerotic Renal Artery Stenosis: A Case Report
腎動脈氣球擴張併支架置放術對於腎動脈狹窄病人血壓及腎功能的影響：病例報告
摘要
動脈硬化引起腎動脈狹窄進而導致嚴重高血壓及腎衰竭是值得注意的重要病因。多年來醫界廣泛使用經皮腎動脈氣球血管擴張併支架置放術來改善病人因腎動脈狹窄所造成的高血壓及腎功能衰竭，但其成效在至今仍無定論，尤其對腎動脈開口處的病灶效果較差。本篇報告一位55歲全身多處動脈血管硬化性阻塞（包括兩側頸動脈、右冠狀動脈、腹主動脈及左側腎動脈開口阻塞）的男性病人，由於難以控制的高血壓、心衰竭及逐漸惡化的腎功能，我們施行右冠狀動脈及左側腎動脈經皮血管氣球擴張併支架置放術。追踪術後一年半此病人的血壓及腎功能變化，血壓仍高且並未因此而減少高血壓藥物的劑量，腎功能亦未得到改善，病人在二年內因肺水腫現象多次住院。單純改善腎臟血流並不能理想的控制高血壓及腎功能，主要的原因包括腎動脈狹窄的時間長短，腎臟本身已因長期的狹窄而有腎病變，腎素－血管張力素的活化等有關。
並列摘要
The prevalence of atherosclerotic renal artery stenosis increases with age, particularly in patients with diabetes, aortoiliac occlusive disease, coronary artery disease, or hypertension. Percutaneous transluminal renal angioplasty with or without stenting for atherosclerotic renal artery stenosis is still controversial, because it is difficult to predict the extent of clinical benefit following renal artery intervention. We followed the variation in renal function and blood pressure for one and a half years in a patient with unilateral atherosclerotic renal artery stenosis after deploying renal stenting. We share the experience that angioplasty with stenting did not preserve renal function, ameliorate blood pressure or reduce episodes of congestive heart failure in our patient with atherosclerotic renal artery stenosis as many published clinical trials have indicated. Therefore, physicians should consider the benefits and complications in recommending angioplasty and stenting of atherosclerotic renal artery stenosis.