Palliative percutaneous transluminal renal angioplasty and stenting in elderly patients for serious coronary heart disease with renal arterial stenosis

Abstract

Abstract: Objective To investigate the feasibility of palliative percutaneous transluminal renal angioplasty (PTRA) and stenting in patients with serious coronary heart disease and renal arterial stenosis. Methods Thirty-four (23 male and 11 female) patients with a mean age of 61.0±11.8 years (ranging from 55 to 78 years) with serious coronary heart disease and renal arterial stenosis,who were unwilling or not suitable to undergo percutaneous coronary intervention and coronary artery bypass grafting,were enrolled in this study.All the cases underwent PTRA and were followed up for 17-53 months (average 35.0±9.3 months).The patients’ renal and cardiac functions and left ventricular ejection fraction (LVEF) were measured in transthoracic echocardiography with the score of SF-36 Health Survey recorded. Results During the follow-up,the weekly incidence of angina pectoris reduced from 14.0±3.9 to 6.5±3.3 (P<0.01) and LVEF increased from (40.2±10.4)% to (45.3±7.8)% (P<0.05).The SF-36 scores were significantly improved from 56.5±8.0 to 80.1±16.8 (P<0.01),with also significant improvement in the subscales of health and daily activity,self-feeling,and general health. Conclusion Palliative PTRA and stenting is feasible and necessary in elderly patients with serious coronary heart disease and renal arterial stenosis when percutaneous coronary intervention or coronary artery bypass graft therapy is not possible.

CLC Number:

GENG Qing-shan, ZHOU Ying-ling, HUANG Wen-hui, LUO Jian-fang, ZHAO Hong-lei, CHEN Ji-yan. Palliative percutaneous transluminal renal angioplasty and stenting in elderly patients for serious coronary heart disease with renal arterial stenosis[J]. Journal of Southern Medical University, 2005, 25(07): 912-913.

References

[1] Diamantopoulos E, Grigoriadou M. Epidemiological and demographic characteristics of chronic peripheral arterial occlusive disease of the lower limbs[J]. Crit Ischaem, 1997, 7(1): 4-13.
[2] 胡大一,马长生.心脏病学实践2002[M].北京:人民卫生出版社,2002.553.
[3] 方积乾.生存质量测定方法及应用[M].北京医科大学出版社,2000.263-8.
[4] Harding MB, Smith LR, Himmelstein SI, et al. Renal artery stenosis:prevalence and associated risk factors in patients undergoing routine cardiac catheterization[J]. J Am Soc Nephrol, 1992, 2(11): 1608-16.
[5] 沈珠军,尚云鹏,朱文玲,等.冠心病患者中肾动脉狭窄的发病情况[J].中华内科杂志,2001,40(8):521-4.Shen ZJ, Shang YP, Zhu WL, et al. The prevalence of renal artery stenosis in patients with coronary artery disease [J]. Chin J Intern Med, 2001, 40(8): 521-4.
[6] Gill KS, Fowler RC. Atherosclerotic renal arterial stenosis: clinical outcomes of stent placement for hypertension and renal failure [J].Radiology, 2003, 226(3): 821-6.
[7] 周颖玲,陈纪言,罗建方,等.冠心病合并外周血管病变的治疗:附21例临床分析[J].中国介入心脏病学杂志,2000,8(3):115-7.
[8] 黄文晖,罗建方,周颖玲,等.严重冠心病合并肾动脉狭窄单纯肾动脉成形术的可行性:附17例随访分析[J].岭南心血管病杂志,2004,10(3):177-9.Huang WH, Luo JF, Zhou YL, et al. The feasibility of single percutaneous revascularisation and stenting to the patients with serious coronary heart disease and renal arterial stenosis [J]. South Chin J Cardiovasc Dis, 2004, 10(3): 177-9.
[9] Staessen JA, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension. The systolic hypertension in europe (Syst-Eur) trial investigators[J]. Lancet, 1997, 350(9080): 757-64.
[10] Amery A, Birkenhager W, Brixko P, et al. Mortality and morbidity results from the European working party on high blood pressure in the elderly trial [J]. Lancet, 1985, 1 (8442): 1349-54.
[11] Hansson L. The captopril prevention project (CAPPP): description and status[J]. Am J Hypertens, 1994, 7(9 Pt 2): 82S-83S.