Hipertensão renovascular no contexto de arterite de Takayasu – a propósito de um caso clínico

Lisa Borges, Rui Machado, Clara Nogueira, Arlindo Matos, Rui Almeida
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Abstract

Introduction

Takayasu's arteritis is a chronic, rare and idiopathic inflammatory disease, which affects the aorta, its main branches, the pulmonary and coronary arteries. The visceral artery most frequently involved is the renal artery, which may lead to renovascular hypertension.

Case report

A 58‐year old woman, with previous history of Takayasu's arteritis and systemic arterial hypertension refractory to treatment. The patient was submitted to aorto‐visceral angiography, showing a right renal artery stenosis, superior to 70% of the estimated diameter, then being submitted to renal artery transluminal angioplasty.

The procedure was technically well‐succeeded and there were no complications related to it. The patient was discharged from hospital in the following day, asymptomatic and presenting arterial blood pressure values within the normal range, with no need for antihypertensive drugs, maintaining this clinical picture at 10 months of follow‐up.

Conclusion

Angioplasty of Takayasu's arteritis induced renal artery stenosis is a safe, effective and low invasive procedure, related to a low complication rate, reasons why this is actually considered the method of choice in the treatment of this pathology.

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高安动脉炎背景下肾血管性高血压-临床病例简介
takayasu动脉炎是一种慢性、罕见的特发性炎症性疾病,主要累及主动脉及其主要分支、肺动脉和冠状动脉。最常累及的内脏动脉是肾动脉,可导致肾血管性高血压。病例报告:一名58岁女性,既往有高松动脉炎和全身性动脉高血压难治性病史。患者接受了主动脉-内脏血管造影,显示右侧肾动脉狭窄,超过估计直径的70%,然后接受了肾动脉腔内血管成形术。手术在技术上很成功,没有并发症。患者于次日出院,无症状,动脉血压值在正常范围内,无需使用降压药,随访10个月后仍保持这一临床表现。结论血管成形术治疗高松动脉炎所致肾动脉狭窄是一种安全、有效、微创的治疗方法,并发症发生率低,是治疗该病的首选方法。
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