腎血管性高血圧症に対する経皮的腎血管形成術の検討

Clinical Experience using Percutaneous Transluminal Renal Angioplasty for Treatment of Renovascular Hypertension

　腎血管性高血圧症7例に対し，経皮的腎血管形成術（PTRA）を施行した．術式はballoon　angioplasty（PTBA）5例，laser assisted balloon angioplasty（LABA）2例であった．全例PTRAは成功し，術前後で血圧は平均171.4／105.7mmHg→143.1／80.0mmHg，狭窄率は82.0±12.6％→25.7±15.5％，血中レニン活性は15.1±6.3ng／ml／hr→3.3±3．Ong／ml／hrといずれも有意に改善が認められた（p＜0.01）また，Duplex超音波断層法による患側腎内葉間動脈の血流動態を術前後に計測したPTRAにより術後最大流速，加速度，平均血流量の上昇，および最低流速／最大流速比の低下が認められたPTRAにおいてPTBA,LABAは有用な術式であり，Duplex超音波断層法は術前後の評価法として優れていた．

Percutaneous transluminal renal angioplasty (PTRA) of seven lesions in seven patients was perfor-med because of renovascular hypertension. Balloon angioplasty (PTBA) was used for five lesions, and laser assisted balloon angioplasty (LABA) was used for two lesions. The stenotic rate of the renal arteries were significantly improved and the blood pressure restored to within normal range in all patients after PTRA. Hemodynamics of the interlobar arteries were mea-sured using Duplex scanning. Maximum velocity, accel-eration and mean blood flow volume were improved after PTRA.