1.Analysis of short-term efficacy of drug-coated balloon in the treatment of atherosclerotic renal artery stenosis
Haozhe ZHANG ; Qiongfang CHANG ; Juanfang LIU ; Xinwei HAN ; Jianhao ZHANG
Journal of Practical Radiology 2025;41(9):1541-1544
Objective To explore the feasibility,safety and efficacy of paclitaxel drug-coated balloon(DCB)in the treatment of atherosclerotic renal artery stenosis(ARAS).Methods A total of 28 patients with ARAS were selected.Balloon angioplasty was performed using a paclitaxel DCB at the site of renal artery stenosis(RAS)in these patients.Subsequently,a follow-up study was conducted to monitor various parameters of the patients,including vascular restenosis,blood pressure,the types of antihypertensive medications and renal function.The feasibility,efficacy and safety of balloon angioplasty using DCB in the treatment of ARAS were analyzed.Results Twenty-eight patients underwent 33 DCB balloon angioplasty.In one patient,there was no significant improve-ment in the degree of RAS,and thus further treatment with renal artery stenting was administered.The remaining patients all achieved both anatomical and hemodynamic success,with the degree of vascular stenosis at the lesion site decreasing from(79.74±5.13)%to(8.32±4.67)%,and the surgical success rate was 96.97%.The systolic/diastolic blood pressure of the patients was(179.16±30.65)mmHg/(108.26±20.93)mmHg(1 mmHg=0.133 kPa)at 24 hours postoperatively,(131.11±12.99)mmHg/(80.11±7.12)mmHg at 3 months postoperatively,(134.16±11.37)mmHg/(78.68±4.79)mmHg at 6 months postoperatively,and(133.37±12.71)mmHg/(80.11±4.84)mmHg at 12 months postoperatively.In comparison with the preoperative blood pressure of(184.63±27.64)mmHg/(109.11±22.26)mmHg,there was no significant decrease in blood pressure at 24 hours postoperatively,and the difference was not statistically significant.However,at 3,6,and 12 months postoperatively,the patients'blood pressure was signif-icantly lower than that before the operation,and all the differences were statistically significant.The glomerular filtration rate(GFR)was(36.19±18.32)mL/min at 24 hours postoperatively,(35.96±18.51)mL/min at 3 months postoperatively,(36.23±19.30)mL/min at 6 months postoperatively,and(35.59±18.26)mL//min at 12 months postoperatively,which all elevated compared with the preoperative GFR of(28.31±14.67)mL/min,and the differences were statistically significant(P<0.05).At 3,6,and 12 months postoperatively,the vascular patency rate was 100%as indicated by multifunctional color Doppler ultrasound examination or renal artery computed tomography angiography(CTA).No relevant com-plications and postoperative adverse events,such as renal artery rupture or dissection,renal artery thrombosis and acute renal insuffi-ciency,occurred in all 28 patients.Conclusion The paclitaxel DCB is safe and reliable for the treatment of ARAS and has remarkable curative effects,and it can be used as an effective vascular treatment regimen for ARAS.
2.Analysis of short-term efficacy of drug-coated balloon in the treatment of atherosclerotic renal artery stenosis
Haozhe ZHANG ; Qiongfang CHANG ; Juanfang LIU ; Xinwei HAN ; Jianhao ZHANG
Journal of Practical Radiology 2025;41(9):1541-1544
Objective To explore the feasibility,safety and efficacy of paclitaxel drug-coated balloon(DCB)in the treatment of atherosclerotic renal artery stenosis(ARAS).Methods A total of 28 patients with ARAS were selected.Balloon angioplasty was performed using a paclitaxel DCB at the site of renal artery stenosis(RAS)in these patients.Subsequently,a follow-up study was conducted to monitor various parameters of the patients,including vascular restenosis,blood pressure,the types of antihypertensive medications and renal function.The feasibility,efficacy and safety of balloon angioplasty using DCB in the treatment of ARAS were analyzed.Results Twenty-eight patients underwent 33 DCB balloon angioplasty.In one patient,there was no significant improve-ment in the degree of RAS,and thus further treatment with renal artery stenting was administered.The remaining patients all achieved both anatomical and hemodynamic success,with the degree of vascular stenosis at the lesion site decreasing from(79.74±5.13)%to(8.32±4.67)%,and the surgical success rate was 96.97%.The systolic/diastolic blood pressure of the patients was(179.16±30.65)mmHg/(108.26±20.93)mmHg(1 mmHg=0.133 kPa)at 24 hours postoperatively,(131.11±12.99)mmHg/(80.11±7.12)mmHg at 3 months postoperatively,(134.16±11.37)mmHg/(78.68±4.79)mmHg at 6 months postoperatively,and(133.37±12.71)mmHg/(80.11±4.84)mmHg at 12 months postoperatively.In comparison with the preoperative blood pressure of(184.63±27.64)mmHg/(109.11±22.26)mmHg,there was no significant decrease in blood pressure at 24 hours postoperatively,and the difference was not statistically significant.However,at 3,6,and 12 months postoperatively,the patients'blood pressure was signif-icantly lower than that before the operation,and all the differences were statistically significant.The glomerular filtration rate(GFR)was(36.19±18.32)mL/min at 24 hours postoperatively,(35.96±18.51)mL/min at 3 months postoperatively,(36.23±19.30)mL/min at 6 months postoperatively,and(35.59±18.26)mL//min at 12 months postoperatively,which all elevated compared with the preoperative GFR of(28.31±14.67)mL/min,and the differences were statistically significant(P<0.05).At 3,6,and 12 months postoperatively,the vascular patency rate was 100%as indicated by multifunctional color Doppler ultrasound examination or renal artery computed tomography angiography(CTA).No relevant com-plications and postoperative adverse events,such as renal artery rupture or dissection,renal artery thrombosis and acute renal insuffi-ciency,occurred in all 28 patients.Conclusion The paclitaxel DCB is safe and reliable for the treatment of ARAS and has remarkable curative effects,and it can be used as an effective vascular treatment regimen for ARAS.
3.A case report of interventional treatment of massive hemorrhage from left ureteral iliac artery fistula
Haozhe ZHANG ; Juanfang LIU ; Chaodi LI ; Su YAN ; Qiongfang CHANG ; Xinwei HAN ; Jianhao ZHANG
Chinese Journal of Urology 2024;45(12):949-951
This article reports that a patient with bilateral ureterocutaneous stoma after radical cystectomy developed intermittent hematuria 2 years after surgery, and there were no abnormalities on bilateral renal artery and abdominal aortic angiography. After removal of the double J stent, a left common iliac artery ureteral fistula was seen on abdominal aortic angiography, and the patient immediately developed hemorrhagic shock. Abdominal aortic balloon occlusion and left common iliac artery stent grafting were performed in the emergency department. After the stent was deployed and the balloon deflated, no bleeding was observed, and the patient's heart rate and blood pressure stabilized. Follow-up angiography showed complete resolution of the fistula. This condition is rare and dangerous, but interventional treatment can quickly control bleeding, offering minimal surgical trauma and fast recovery.
4.A case report of interventional treatment of massive hemorrhage from left ureteral iliac artery fistula
Haozhe ZHANG ; Juanfang LIU ; Chaodi LI ; Su YAN ; Qiongfang CHANG ; Xinwei HAN ; Jianhao ZHANG
Chinese Journal of Urology 2024;45(12):949-951
This article reports that a patient with bilateral ureterocutaneous stoma after radical cystectomy developed intermittent hematuria 2 years after surgery, and there were no abnormalities on bilateral renal artery and abdominal aortic angiography. After removal of the double J stent, a left common iliac artery ureteral fistula was seen on abdominal aortic angiography, and the patient immediately developed hemorrhagic shock. Abdominal aortic balloon occlusion and left common iliac artery stent grafting were performed in the emergency department. After the stent was deployed and the balloon deflated, no bleeding was observed, and the patient's heart rate and blood pressure stabilized. Follow-up angiography showed complete resolution of the fistula. This condition is rare and dangerous, but interventional treatment can quickly control bleeding, offering minimal surgical trauma and fast recovery.

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