Endovaskuläre Therapie der Nierenarterienstenose

Zusammenfassung

Angioplastie und Stent-Therapie von Verengungen der Nierenarterie gehören längst zum Alltagsgeschäft interventioneller Radiologen. Neuere Untersuchungen stellen jedoch die klinische Bedeutung der Methode infrage. Der Beitrag beschäftigt sich zunächst mit der Technik der endovaskulären Therapie von Stenosen der Nierenarterie und damit, wie die Ätiologie der Erkrankung das Ansprechen auf PTA bzw. Stent beeinflusst. Anschließend wird die aktuelle Bedeutung der Revaskularisation für die Behandlung einer renalen Hypertonie und einer Niereninsuffizienz analysiert und gezeigt, wo heute eine Therapie auch in Konkurrenz zu anderen Verfahren sinnvoll ist. Im Ergebnis soll der Artikel praktische Anleitung geben, welche Stenose in verschiedenen klinischen Konstellationen behandelt werden soll.

Abstract

Percutaneous transluminal balloon angioplasty and stenting for renal artery stenoses have become routine in the day-to-day life of interventional radiologists. New studies, however, have questioned the role of this methodology. This review discusses the technique of endovascular therapy for renal artery stenoses and the impact of the pathoanatomic differences on the outcome of angioplasty or stenting. Furthermore, the current role of revascularisation in the treatment of renal hypertension and renal insufficiency is analyzed and its contribution in competition with other methods is demonstrated. It is the goal of this review to give practical advice how to treat stenoses found in various clinical settings.

Key words

Biopsies, - Interventional procedures; - kidney, interventional procedures; - arteriosclerosis; - arteries, transluminal angioplasty; - stents and prostheses; - hypertension, renovascular

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