血管内支架置入术治疗钝性肾动脉损伤的有效性和安全性:部分闭塞5例

Ichiro Okada, N. Kiriu, Junichi Inoue, H. Kato, Y. Koido, T. Hattori, Kohei Morimoto
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摘要

目的:肾动脉支架置入术的目的是保护肾功能,预防肾血管性高血压。我们在此评估了肾动脉支架置入术治疗钝性肾动脉损伤的有效性和安全性。材料和方法:我们回顾性分析了5例(4男1女)部分闭塞肾动脉损伤患者,这些患者在我院接受支架置入术治疗的时间超过10年。结果:跌倒致伤4例,车祸致伤1例。所有患者均为多发损伤(损伤严重程度评分中位数为32;范围,22-57)。中位生存概率为0.547(0.533-0.980)。中位随访时间为12(3-110)个月。虽然两名患者出现可逆性急性肾功能衰竭,但没有人需要永久性血液透析。所有患者均存活,无直接支架置入并发症。在随访中,对比计算机断层扫描显示肾动脉通畅,没有肾萎缩。3例患者行肾显像检查,显示肾功能保留。一名肾血管性高血压患者成功地用降压药治疗了一个月,随后血压正常,不需要进一步的药物治疗。结论:所有肾动脉支架置入术患者均存活,无直接并发症。肾功能完好,无永久性肾血管性高血压。因此,我们认为肾动脉支架置入术对于部分闭塞的钝性肾动脉损伤是一种有效且有利的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness and safety of endovascular stenting for blunt renal artery injury: partially occluded five cases
Objective : The purpose of renal artery stent placement is to preserve renal function and prevent renovascular hypertension. We here evaluated the effectiveness and safety of renal artery stent placement for blunt renal artery injury at our institution. Materials and Methods : We retrospectively reviewed five patients (4 males, and 1 female) with partially occluded renal artery injury that had been treated with stenting over a 10-year period at our institution. Results : Trauma resulted from falling in four patients and a motor vehicle accident in one. All patients received mul-tiple injuries (median injury severity score, 32; range, 22-57). Median survival probability was 0.547 (0.533-0.980). And median follow-up duration was 12 (3-110) months. Although two patients developed reversible acute renal failure, none required permanent hemodialysis. Furthermore all patients survived, and no direct stenting complications were observed. At follow-up, contrast computed tomography scanning showed renal artery patency and an absence of renal atrophy in these patients. Renal scintigraphy was performed in three patients and showed renal function preservation. One patient with renovascular hypertension was successfully treated with antihypertensive agents for a month and subsequently became normotensive without requiring further medication. Conclusions : All patients survived renal artery stenting with no direct complications. In addition, the renal function was preserved without permanent renovascular hypertension. We therefore consider that renal artery stent placement is an effective and favorable treatment option for partially occluded blunt renal artery injury.
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