Moyamoya Disease with Renal Artery and External Iliac Artery Stenosis

We report a case of right external iliac artery stenosis after kidney transplantation surgery caused by vascular clamp application injury. The patient presented with claudication of the ipsilateral lower limb and the lesion was diagnosed angiographically. The patient was treated with endovascular stent placement.

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Transplant Renal Artery Stenosis Revascularization: Common Distal External Iliac Bypass

International Journal of Angiology ◽

10.1055/s-0040-1714663 ◽

2020 ◽

Author(s):

Santiago J. Miyara ◽

Christopher C. Ortiz ◽

Sara Guevara ◽

Alexia Molmenti ◽

Gerardo Tamayo-Enriquez ◽

...

Keyword(s):

Lower Extremity ◽

Renal Artery ◽

Iliac Artery ◽

Duplex Ultrasound ◽

External Iliac Artery ◽

Artery Stenosis ◽

Ptfe Graft ◽

Transplanted Kidney ◽

Renal Hilum ◽

Arterial Anastomosis

AbstractStenosis proximal to transplant renal artery anastomoses are complications leading to allograft dysfunction. This study was aimed to evaluate a novel surgical approach to renal allograft revascularization, taking into consideration the length of time elapsed since transplantation. We describe an arterial bypass using a polytetrafluoroethylene (PTFE) graft from the common iliac artery (proximal to the renal artery implantation) to the external iliac artery (distal to the renal artery implantation) that allows the adequate revascularization of both the transplant kidney, as well as the lower extremity. This technique provides several advantages when compared with previously described procedures to revascularize a transplanted kidney with an iliac artery stenosis proximal to the allograft implantation site. Benefits of this technique include (1) no need to repair the stenosis, (2) no need to take down and redo the arterial anastomosis, (3) no need to perform a dissection around the renal hilum of the transplanted kidney, (4) no requirement to address the anastomosis transfer, and (5) no need to perfuse the kidney with preservation fluid at the time of repair and/or (6) avoidance of potential injury to the renal parenchyma and/or hilum during dissections. Adequate perfusion of the organ, as well as of the lower extremity was verified by serial Doppler duplex ultrasound evaluations. Hence, we describe a novel revascularization technique in instances of kidney transplant and lower extremity ischemia.

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Simultaneous endovascular revascularization of external iliac artery dissection and transplant renal artery stenosis in a recent renal allograft recipient

Jornal Vascular Brasileiro ◽

10.1590/1677-5449.210035 ◽

2021 ◽

Vol 20 ◽

Author(s):

Rajesh Vijayvergiya ◽

Atit Gawalkar ◽

Ganesh Kasinadhuni ◽

Ashish Sharma ◽

Sarbpreet Singh ◽

...

Keyword(s):

Renal Transplantation ◽

Renal Artery ◽

Renal Artery Stenosis ◽

Iliac Artery ◽

Vascular Complications ◽

External Iliac Artery ◽

Artery Stenosis ◽

Artery Dissection ◽

Renal Allograft Recipient ◽

Transplant Renal Artery Stenosis

Abstract Various vascular complications following renal transplantation include renal artery and vein thrombosis, renal artery stenosis, pseudoaneurysm, and iliac artery dissection. Transplant renal artery stenosis (TRAS) is the most common, while iliac artery dissection is the rarest of these various vascular complications. We describe an elderly male, who had both external iliac artery dissection and TRAS at 2 months following renal transplantation. He underwent successful percutaneous endovascular intervention of both complications. The post-intervention course was uneventful, with improvement in graft renal functions and left lower limb perfusion.

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Determination of the Best Parameter for Defining the Hemodynamic Significance of an Iliac Artery Stenosis Detected on Computed Tomography Angiography

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2015.09.005 ◽

2016 ◽

Vol 67 (3) ◽

pp. 298-303

Author(s):

Nick Lougheed ◽

Jeff Jaskolka ◽

Rob Beecroft ◽

Ravi Menezes

Keyword(s):

Computed Tomography ◽

Iliac Artery ◽

Computed Tomography Angiography ◽

External Iliac Artery ◽

Artery Stenosis ◽

Minimum Diameter ◽

Significant Stenosis ◽

Iliac Artery Stenosis ◽

The Common ◽

Best Parameter

Purpose The purpose of this study was to determine the best parameter, derived from computed tomography angiography (CTA) for accurate prediction of a hemodynamically significant stenosis of the common or external iliac artery. Methods A retrospective keyword search was performed on the Radiology Information System at our tertiary academic medical centre. Reports from January 2008 to September 2013 were searched using the keywords iliac, stenosis, and pressure. Patients who had both and CTA and a pelvic angiogram with pressure measurements obtained across a potential stenosis were selected. Using 3D postprocessing software (TeraRecon, Foster City, CA), the CTAs were analysed for the following parameters of each lesion: minimum diameter of stenosis, minimum cross-sectional area of stenosis, percent narrowing of vessel diameter, and percent reduction in vessel area. The percent stenosis was calculated in reference to the outer diameter at the point of maximal narrowing and also in reference to a normal segment of vessel more distal to the stenosis. These parameters were then compared with the measured pressure gradient using receiver-operating characteristic analysis and the Mann-Whitney U test to determine which best predicted a significant stenosis, defined as a greater than 10% drop in systolic pressure across a lesion. Results One hundred and two stenoses in 83 patients (26 women, 57 men; 47-88 years old) were identified. Mean diameter of the stenosis was 2.8 mm for significant stenosis compared to 3.8 mm in nonsignificant stenoses ( P = .005). Mean minimum area for significant stenoses was 11.8 mm2 compared to 17.22 mm2 for nonsignificant stenoses ( P = .032) No other variables showed a significant difference between significant and nonsignificant stenoses. A minimum diameter of ≤4.0 mm at the level of a stenosis is 92% sensitive and 48% specific for predicting a hemodynamically significant iliac artery stenosis, with a positive predictive value of 88%. Conclusions A simple measurement of the minimum diameter of an iliac artery at the level of stenosis is the best predictor of the hemodynamic significance of a stenosis in the common or external iliac artery.

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Managing External Iliac Artery stenosis due to iatrogenic injury after Kidney Transplant (KTX)

10.26226/morressier.5a38ffa4d462b8029238b6e3 ◽

2018 ◽

Author(s):

Olga Manolitsi

Keyword(s):

Kidney Transplant ◽

Iliac Artery ◽

External Iliac Artery ◽

Iatrogenic Injury ◽

Artery Stenosis ◽

Iliac Artery Stenosis

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External iliac artery stenosis in a young body builder

European Journal of Vascular and Endovascular Surgery ◽

10.1016/s1078-5884(96)80189-4 ◽

1996 ◽

Vol 11 (4) ◽

pp. 499-501 ◽

Cited By ~ 17

Author(s):

H.S. Khaira ◽

R.W. Awad ◽

N. Aluwihare ◽

C.P. Shearman

Keyword(s):

Iliac Artery ◽

External Iliac Artery ◽

Artery Stenosis ◽

Iliac Artery Stenosis ◽

Body Builder

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Close to Transplant Renal Artery Stenosis and Percutaneous Transluminal Treatment

Journal of Transplantation ◽

10.1155/2011/219109 ◽

2011 ◽

Vol 2011 ◽

pp. 1-7 ◽

Cited By ~ 6

Author(s):

Leonardou Polytimi ◽

Gioldasi Sofia ◽

Pappas Paris

Keyword(s):

Renal Artery ◽

Renal Artery Stenosis ◽

Iliac Artery ◽

Graft Function ◽

Artery Stenosis ◽

Arterial Stenosis ◽

Transplant Renal Artery Stenosis ◽

Iliac Artery Stenosis ◽

Angioplasty And Stenting ◽

Percutaneous Transluminal

Purpose. To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in the management of arterial stenosis located close to the allograft anastomosis (close-TRAS).Materials and Methods. 31 patients with renal transplants were admitted to our institution because of persistent hypertension and impairment of transplant renal function and underwent angiography for vascular investigation. 27 were diagnosed suffering from transplant renal artery stenosis (TRAS), whereas 4 had severe iliac artery stenosis proximal to the transplant anastomosis (Prox-TRAS). 3 cases of TRAS coexisted with segmental renal arterial stenosis, whereas 3 other cases of TRAS were caused by kinking and focal stenosis in the middle of the transplanted renal artery.Results. Angioplasty and stenting were successfully applied to all patients with iliac artery stenosis as well as to those with TRAS and segmental artery stenosis. Two of three patients with kinking were well treated with angioplasty and stenting, whereas one treated only with angioplasty necessitated surgery. No major procedure-related complications appeared, and the result was decrease of the serum creatinine level and of the blood pressure.Conclusions. PTA is the appropriate initial treatment of TRAS and close-TRAS, with low morbidity and mortality rates, achieving improvement of graft function and amelioration of hypertension.

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