Dergiler / Anadolu Kardiyoloji Dergisi / 2003 / Cilt: 3 - Sayı: 1
Renal arter darlığı saptanan hipertansif hastalarda renal artere stent uygulaması: Dokuz aylık takip sonuçları
- Sayfa
- 2–7
- DOI
- —
Özet
Amaç: Proksimal-ostiyal renal arter darlığı saptanan hipertansif hastalarda renal arter stent uygulamasının kan basıncı ve renal fonksiyonlara etkisini araştırdık. Yöntem: Çalışmaya aterosklerotik renal arter stenozu saptanan yaş ortalaması 59.0±7.4 yıl , 9 kadın, 17 erkek 26 hipertansif hasta alındı. Olguların işlem öncesi, sonrası 24. saat, 3.ay ve 9. ayda, kan basıncı, üre ve kreatinin değerleri ölçüldü. Bulgular: Tüm hastalarda işlem başarı ile sonuçlandı. On altı (% 51) olguda predilatasyon sonrası ,10 (%49) olguda predilatasyon yapılmaksızın stent yerleştirildi. Ortalama stent çapı 7.11 ± 0.3mm, stent uzunluğu 15.36 ± 2.2 mm idi. Antihipertansif ilaç kullanımı olguların 6' sında (%23) kesildi, 15 'inde (%58) ilaç sayısı azaltılırken ,5 olguda (%19) ilaç dozu değiştirilemedi. Plazma kreatinin değerlerinde anlamlı değişim olmadı (p
Abstract
Objective: We evaluated the effects of stenting on blood pressure and renal functions in hypertensive patients with proximal/ostial atherosclerotic renal artery stenosis. Methods: Twenty-six hypertensive patients (9 female, 17 male, mean age 59.0±7.4 years) who had renal artery stenosis were included into this study. Their blood pressure, urea and creatinine levels were measured at 24 hours, 3 months and 9 months after procedure. Results: Stents were implanted successfully in all cases. Implanting of stent was done with predilatation in 16 (5 %) cases and without predilatation (direct stenting) in 10 (49%) cases. Mean stent diameter and stent length were 7.11±0.3 mm and 15.0±2.2mm respectively. The antihypertensive drug therapy was stopped in 6 (23%) patients, decreased in 15 patients (58 %) and did not change in 5 (19 %) patients. No significant changes were observed in urea and creatinine levels. However, creatinine levels were lower after procedure in direct stenting patients than in patients in whom predilatation was applied (0.78±0.3 mm; 1.32±0.6, p=0.003). This difference disappeared on the 3rd month of follow-up. One patient died during follow-up period. Control angiography was performed in 23 patients. Angiographic restenosis was found in 1 (4.3%) patient. Major events during follow-up period occurred in 2 (8 %) patients. Conclusion: Stenting in hypertensive patients with renal artery stenosis is reliable and effective procedure. Selection the stenting procedure with or without predilatation depends on the clinical status of patient and the choice of the interventional team.