RESULTS: Of 30 patients undergoing renal artery stenting, 18 patients were deemed \"high-risk.\" On short term, good in-hospital control of hypertension and cardiac stabilization were obtained in all patients. Renal function improved significantly only in patients admitted with rapidly declining renal function, with significant creatinine level fall from median 3.98 mg/dL to 2.02 mg/dL, p = 0.023. However, for the whole group, creatinine change was non-significant (- 0.12 mg/dL, p = NS). On the long term, five patients (27.8%) ended-up on chronic hemodialysis and six patients died (33.3%) after a median of 20 months. No death occurred during the first year after the procedure.
CONCLUSIONS: Percutaneous procedures are feasible and safe in patients with high-risk renal artery stenosis, especially in those with rapidly declining renal function, probably saving some of them from the immediate need for renal replacement therapy, but long-term results are negatively influenced by the precarious general and cardio-vascular status of these patients and by the pre-existing significant renal parenchymal disease, non-related to the renal artery stenosis.
结果:在接受肾动脉支架置入术的30例患者中,18例患者被认为是“高风险”。\"在短期内,所有患者均获得了良好的高血压和心脏稳定的院内控制.仅在肾功能迅速下降的患者中,肾功能明显改善。肌酐水平从中位数3.98mg/dL降至2.02mg/dL,p=0.023。然而,对于整个团队来说,肌酐变化无统计学意义(-0.12mg/dL,p=NS)。从长远来看,5例患者(27.8%)最终接受了慢性血液透析,6例患者在中位时间20个月后死亡(33.3%).手术后的第一年没有死亡。
结论:经皮手术对于高危肾动脉狭窄患者是可行和安全的,尤其是那些肾功能迅速下降的患者,可能使他们中的一些人免于立即需要肾脏替代治疗,但长期结果受到这些患者不稳定的全身和心血管状态以及预先存在的显著肾实质疾病的负面影响,与肾动脉狭窄无关。