肾动脉狭窄支架术现状演示文稿.pptVIP

本文档共49页；当前第31页；编辑于星期二\5点56分 本文档共49页；当前第32页；编辑于星期二\5点56分 Why some Pt. gain no benefit from RAS stenting? 本文档共49页；当前第33页；编辑于星期二\5点56分 Renal parenchyma impairment diabetic nephropathy renal impairment due to HT renal impairment due to others Ischemic nephropathy Age CIN Restenosis factors Influencing the outcomes in RAS underwent stent 本文档共49页；当前第34页；编辑于星期二\5点56分 nephron redunction volume-dependent hypertension：(Bil RAS/renal dysfunction) renin-dependent hypertension：(uni RAS) sympathetic nervous system vasoactive substance secreted from kidney：natriuretic hormone vasopressin Mechanism of hypertension in CKD 本文档共49页；当前第35页；编辑于星期二\5点56分 Renal arteriolar sclerosis in benign hypertension Early stage：hyalinization in afferent glomerular arteriole and arteria interlobulares advanced stage：glomerulus, nephric tubule, renal interstitium disease renal arteriolar sclerosis in malignant hypertension (DBP120mmHg) Necroticarteriolitis, Proliferating endarteritis Pathology of hypertension-induced renal impairment 本文档共49页；当前第36页；编辑于星期二\5点56分 Nephrosis dut to cholesterol crystal embolization Epidemiology： author population cases incidence(%) Flory Aorta AS 267 3.3 Oross autopsy 3722 2.4 Jones Unexplained renal dysfunction 245 1.0 Preston 65 years 334 4.2 etiological factor：AS、endovascular procedure 本文档共49页；当前第37页；编辑于星期二\5点56分 Henry (Percusurge)AJC Oct,2000 TCT 30 RAS of 24 Pt. (27 ostial) All had renal impairement, 71% had HT Success rate 100% Occlusion time 418 sec(149-797) Embolization after stenting 本文档共49页；当前第38页；编辑于星期二\5点56分 Embolization after stenting Improved renal function 46% Unchanged 4% Acute deterioration 0% No renal function deterioretion at 6 month 6/30(20%) empty 24/30(80%)had filter content Chronic thrombus Cholesterol clefts fragment 本文档共49页；当前第39页；编辑于星期二\5点56分 Kidney in elderly Kid