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Offene und endovaskuläre Therapie von Nierenarterienstenosen

Open and endovascular treatment of renal artery stenosis

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Zusammenfassung

Hintergrund

Aufgrund mehrerer randomisierter Studien wird aktuell jedwede Therapie an den Nierenarterien hinterfragt. Leitlinien haben versucht, Indikatoren zu erarbeiten, die für eine Therapie der Nierenarterien sprechen.

Material und Methoden

Technik und Ergebnisse der endovaskulären und operativen Therapie von Nierenarterienstenosen werden anhand der Literatur bzw. eigener Erfahrung vorgestellt.

Diskussion

Bei Vorliegen einer Nierenarterienstenose besteht weiterhin eine Indikation zur invasiven Therapie bei rezidivierenden Lungenödemen sowie bei akuter Verschlechterung der Nierenfunktion oder des Blutdrucks. Die Ergebnisse sowohl der endovaskulären als auch der operativen Therapie der Nierenarterienstenose sind sehr gut, mit einem Vorteil für den Langzeitverlauf bei operativ behandelten Patienten. Eine gute interdisziplinäre Zusammenarbeit ist in der Therapie dieses Krankheitsbildes obligat.

Abstract

Background

Based on several randomized studies, currently any treatment concerning the renal arteries seems questionable. Guidelines have tried to establish indicators that are in favor of a treatment of the renal arteries.

Material and methods

The technique and results of endovascular and surgical treatment of stenosis of the renal arteries are presented based on the literature and the author’s own experience.

Discussion

The indications for invasive treatment still consist of recurrent flash pulmonary edema and rapid deterioration of renal function or hypertension in the presence of renal artery stenosis. The results of endovascular and surgical treatment of renal artery stenosis are very good, with an advantage for the long-term course of surgically treated patients. Interdisciplinary cooperation is mandatory in the treatment of this disease.

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Authors and Affiliations

  1. Abteilung für Gefäß- und Endovaskularchirurgie, GFO-Kliniken Bonn, Betriebsstätte St. Marien-Hospital, Robert-Koch-Str. 1, 53115, Bonn, Deutschland

    Kai M. Balzer

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Correspondence to Kai M. Balzer.

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K.M. Balzer gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Balzer, K.M. Offene und endovaskuläre Therapie von Nierenarterienstenosen. Gefässchirurgie 27, 408–415 (2022). https://doi.org/10.1007/s00772-022-00927-9

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