肾血管病的处理.pptVIP

ManagementofRenovascularHypertension

;InterrelationamongRenalArteryStenosis,Hypertension,andChronicRenalFailure;

DefinitionofRenalArteryStenosis

Renalarterystenosis(RAS)isdefinedasnarrowingofthelumenoftherenalartery.

*angiographicdiameterstenosis50%

*translesionalpressuregradientof20mmHgpeaksystolic

or10mmHgmean

ThemostcommoncausesofRASareatherosclerosis(80%),aortoarteritis(15%),andfibromusculardysplasia(5%)inChina

;Prevalence;IncidenceofRenalArteryStenosis

atCardiacCatheterization

;IncidenceofRenalArteryStenosisatCardiacCatheterization

inChinesepopulation;;theclinicalmanifestationsofARVD;ScreeningforRenovascularHypertension;Severityofrenalvasculardiseasepredictsmortalityinpatientsundergoingcoronaryangiography

KidneyInternational(2001)60,1490–1497

;;ClinicalCriteriaforRevascularization;MedicalTherapy;肾动脉支架置入;术前准备;EndovascularTreatmentofRenalArteryStenoses;.014Stabilizer+6FBriteTipSheath55cm;EndovascularTreatmentofRenalArteryStenoses;RenalArteryStenting;Casereport-1;;术后随访;ARVD–RandomizedStudies

PTRAvsMedication;肾动脉支架的临床结果

;ASTRAL

AngioplastyandSTentforRenalArteryLesions

UKMULTI-CENTRETRIALIN

ATHEROSCLEROTICRENOVASCULARDISEASE;ASTRALTrial:Design;PrimaryandsecondaryendpointsinASTRAL

;StentMedRxpValue;ASTRAL:LesionSeverity;ASTRAL:Treatment;ASTRAL:PrimaryEndpoint,1/Cr;ASTRAL:ChangeinSystolicBP;ASTRALEventComposite:

MI,StrokeVascularDeathHospitalizationforAngina,FluidOverloadorCHF;以前的RCT研究;质疑-1;质疑-2;ASTRAL:LesionSeverity;质疑-3

在流量大、介入标准严格的医疗中心采用肾动脉支架术治疗ARVD患者的非随机研究结果优于随机的支架治疗组。

preservesrenalfunction:Metaanalysis;药物治疗与介入治疗的随机对比研究

可靠吗？;ASTRAL等随机临床研究的启示;

经皮支架重建血运治疗粥样硬化性肾动脉狭窄的中远期临床结果

;有效？;资料与方法;结果-患者的基本临床特征;结果-患者的基本临床特征;PTRAS的造影和支架结果及并发症;结果-随访及失访情况;PTRAS对血压的影响;PTRAS对肾功???的影响;PTRAS后血压和肾功能转归;本研究PTRAS后的无事件生存率;PTRAS后的心血管事件;

随访期患者发生各种心血管事件的相关因素