Current issues in the diagnosis and management of patients with renal artery stenosis: a cardiologic perspective.

Haller C; Keim M

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Current issues in the diagnosis and management of patients with renal artery stenosis: a cardiologic perspective.

机译：肾动脉狭窄患者诊断和治疗的当前问题：心脏病学的观点。

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Renal artery stenosis most often is caused by atherosclerosis. Although patients with renal artery stenosis can be managed conservatively, renal revascularization may be indicated, particularly in patients with refractory hypertension on a multidrug regimen and patients with declining renal function. Duplex ultrasonography of the renal arteries and magnetic resonance angiography are currently the most efficient noninvasive methods for the evaluation of renal artery stenosis. Selective digital subtraction renal arteriography remains the gold standard for the definitive diagnosis. In selected patients undergoing coronary studies and angiography immediately after the coronary procedure can be efficient. Atherosclerotic renal artery lesions, which commonly affect the renal artery ostium, can be treated safely and effectively with balloon-expandable stents. Successful angioplasty commonly results in improved control of hypertension, but an overall benefit on renal function and/or patient survival has not been shown. Generally the risk/benefit ratio of renal artery stenting seems favorable, but further randomized studies are needed for evidence-based decision making. All patients with atherosclerotic renal artery stenosis should receive rigorous secondary prevention measures including platelet inhibitors, statins, and beta-blockers.

机译：肾动脉狭窄通常是由动脉粥样硬化引起的。尽管肾动脉狭窄的患者可以保守治疗，但可能需要进行肾血运重建，特别是在采用多种药物治疗的难治性高血压患者和肾功能下降的患者中。肾动脉的双重超声检查和磁共振血管造影术是目前评估肾动脉狭窄的最有效的非侵入性方法。选择性数字减影肾动脉造影仍然是明确诊断的金标准。在选定的患者中，在冠状动脉手术后立即进行冠状动脉研究和血管造影可能是有效的。通常会影响肾动脉口的动脉粥样硬化性肾动脉病变可以通过气囊扩张式支架安全有效地治疗。成功的血管成形术通常可改善对高血压的控制，但尚未显示出对肾功能和/或患者生存的总体益处。通常，肾动脉支架置入术的风险/获益比似乎是有利的，但是基于证据的决策还需要进一步的随机研究。所有患有动脉粥样硬化性肾动脉狭窄的患者均应接受严格的二级预防措施，包括血小板抑制剂，他汀类药物和β-受体阻滞剂。

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《Progress in Cardiovascular Diseases》 |2003年第3期|共16页
作者
Haller C; Keim M;
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正文语种 eng
中图分类内科学;
关键词
Arteriosclerosis; Renal Artery Obstruction; 动脉硬化; 肾动脉梗阻;

机译：Arteriosclerosis;Renal Artery Obstruction;动脉硬化;肾动脉梗阻;

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1. Current issues in the diagnosis and management of patients with renal artery stenosis: a cardiologic perspective. [J] . Haller C, Keim M Progress in Cardiovascular Diseases . 2003,第3期

机译：肾动脉狭窄患者诊断和治疗的当前问题：心脏病学的观点。
2. Diagnosis and management of atherosclerotic renal artery stenosis: improving patient selection and outcomes. [J] . White CJ, Olin JW Nature clinical practice. Cardiovascular medicine . 2009,第3期

机译：动脉粥样硬化性肾动脉狭窄的诊断和处理：改善患者选择和治疗效果。
3. Impact of Levovist ultrasonographic contrast agent on the diagnosis and management of hypertensive patients with suspected renal artery stenosis: a Canadian multicentre pilot study. [J] . Lacourciere Y, Levesque J, Onrot JM, Canadian Association of Radiologists journal . 2002,第4期

机译：Levovist超声造影剂对疑似肾动脉狭窄的高血压患者的诊断和管理的影响：一项加拿大多中心先导研究。
4. Ultrasound evaluation of the efficacy of angioplasty for renal artery stenosis [C] . Yang Bai, Guanghong Han, Xiadong Du, International Conference on Biological Information and Biomedical Engineering . 2019

机译：超声评价血管成形术治疗肾动脉狭窄的疗效
5. Middle Aortic Syndrome and Renal Artery Stenosis: Disease beyond the Arch [D] . Rumman, Rawan K. 2016

机译：中间主动脉综合征和肾动脉狭窄：疾病超越拱门
6. Renal autotransplantation for the management of renal artery in-stent restenosis in an adult patient with Takayasu arteritis [O] . Rajesh Vijayvergiya, Ashish Sharma, Kewal Pravin Kanabar, 2018

机译：肾自聚体对高山动脉炎的成人患者肾动脉内切断治疗
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8. Renal Artery Stenosis Management Strategies: An Updated Comparative Effectiveness Review. Comparative Effectiveness Review Number 179. [R] . 2016

机译：肾动脉狭窄管理策略：更新的比较效果评估。比较效力审查编号179。

Current issues in the diagnosis and management of patients with renal artery stenosis: a cardiologic perspective.

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