Clinical features and prognosis of patients with moyamoya disease and renal artery stenosis
11.3969/j.issn.1672-5921.2015.04.004
- VernacularTitle:烟雾病合并肾动脉狭窄的临床特征及治疗预后
- Author:
Zhengshan ZHANG
;
Huaitao YANG
;
Rui ZHANG
;
Lian DUAN
- Publication Type:Journal Article
- Keywords:
Moyamoya disease;
Renal artery obstruction;
Disease attributes;
Endovascular treatment
- From:
Chinese Journal of Cerebrovascular Diseases
2015;(4):185-188
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical features and prognosis of patients with moyamoya disease and renal artery stenosis. Methods The clinical data such as the first symptom,intracranial vascular lesions,renal artery lesions,treatment and follow-up results of the 15 patients with moyamoya disease and complicated with renal artery stenosis (RAS group)and the baseline-matched 30 moyamoya diseased patients without renal artery stenosis (MMD group)treated at the Department of Neurosurgery,the 307 th Hospital of People′s Liberation Army from March 2009 to June 2012 were analyzed retrospectively. Results (1)The moyamoya diseased patients with renal artery stenosis accounted for 1. 6%(15 / 927)of the total number of patients with moyamoya disease admitted in the same period. In the RAS group,the left renal artery stenosis accounted for 5 cases,the right renal artery stenosis accounted for 4 cases,and the bilateral renal artery stenosis accounted for 6 cases. Mild stenosis accounted for 71. 4%(15 / 21 sides), proximal stenosis accounted for 85. 7% (18 / 21 sides). The incidence of hypertension (80. 0%,n = 12) of the RAS group was significantly higher than that of the MMD group (30. 0%,n =9). There was significant difference (χ2 = 10. 045,P < 0. 05). There was significant difference in the distribution of Suzuki stage between the patients of the two groups (Z = -6. 184,P <0. 01). (2)Four patients underwent interventional therapy,their blood pressure decreased to normal level after procedure. Three patients were followed up for 9 months to 108 months with angiography after interventional treatment. No restenosis occurred in renal artery.
Conclusion The incidence of hypertension in patients with RAS is significantly higher than that without RAS,and there is difference between the degree of intracranial vascular lesions and the patients without RAS. Renal artery stenosis is mainly the proximal mild stenosis. Interventional therapy is an effective method for the treatment of moyamoya disease with severe renal artery stenosis;however,the long-term prognosis needs to be further followed up.
