Endovascular Treatment of Transplant Renal Artery Stenosis: Evaluation of Postoperative Outcomes and Risk Factors for Recurrence

Angiology ◽  
2018 ◽  
Vol 70 (3) ◽  
pp. 249-256 ◽  
Author(s):  
François-René Roustan ◽  
Fabien Lareyre ◽  
Imad Bentellis ◽  
Romain Haider ◽  
Stéphanie Torrino ◽  
...  

Angioplasty with or without stenting has become a well-established procedure to treat transplant renal artery stenosis (TRAS). We evaluated our experience on postoperative outcomes following the intervention and identified potential predictive factors of TRAS recurrence. Consecutive patients who underwent endovascular treatment of TRAS were retrospectively reviewed. The study end points were the technical success, 30-day postoperative complications, and the estimated glomerular filtration rate (eGFR). Thirty-two patients underwent endovascular treatment for TRAS. The technical success rate was 96.6%. Complications were observed for 7 (21.9%) patients: 4 had a dissection, 2 a pseudoaneurysm, and 1 (3.1%) patient developed an acute pulmonary edema. The mean eGFR significantly increased at 7 days, 3 months, and 6 months postintervention (43.1, 44.9, and 44.3 vs 33.9 mL/min/1.73 m2 preoperatively, P < .05). The TRAS recurrence was observed in 7 (21.9%) patients. These patients had significantly higher preoperative peak systolic velocity and systolic rise time (5 vs 4 m/s, P = .0383 and 103 vs 80 milliseconds, P = .0148, respectively). Endovascular treatment of TRAS is associated with high technical success and significant improvement in renal function. Further studies are required to confirm predictive factors of TRAS recurrence following endovascular treatment.

2013 ◽  
Vol 29 (3) ◽  
pp. 461-467 ◽  
Author(s):  
Giulia Ghirardo ◽  
Marco De Franceschi ◽  
Enrico Vidal ◽  
Alessandro Vidoni ◽  
Gaetano Ramondo ◽  
...  

Medicine ◽  
2021 ◽  
Vol 100 (32) ◽  
pp. e26935
Author(s):  
Youngmin Kim ◽  
Mi Hyeong Kim ◽  
Jeong Kye Hwang ◽  
Sun Cheol Park ◽  
Ji Il Kim ◽  
...  

2016 ◽  
Vol 51 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Lili Wang ◽  
Bin Liu ◽  
Jieke Yan ◽  
Yongzheng Wang ◽  
Wujie Wang ◽  
...  

Purpose: To evaluate the outcomes of percutaneous intervention (PI) for transplant renal artery stenosis (TRAS). Materials and Methods: Doppler ultrasonography was used as the screening tool, and angiography was the diagnostic method for TRAS. The indications for PI were (1) a reduction in lumen diameter of >50% or (2) a mean pressure gradient of >15 mm Hg. Technical success was assessed immediately after the procedure. The short-term results of stenosis were evaluated by serum creatinine (Scr) levels and blood pressure (BP). The long-term results were assessed by graft survival and renal function. Results: From October 2009 to July 2015, a total of 660 patients had kidney transplantation and 22 cases underwent PI. The technical success was 100%. The mean Scr level preintervention was 321.6 ± 167.2 (range, 171.3-862.0) μmol/L, and it decreased to 145.3 ± 44.7 (range, 74.3-260.8) μmol/L 1 month postintervention ( P < .001). Blood pressure was also improved at 1 month postintervention, as assessed by systolic (157.0 ± 13.0 vs 131.0 ± 11.0 mm Hg, P < .001), diastolic (95.0 ± 5.0 vs 77.0 ± 9.0 mm Hg, P < .001), and mean arterial pressure (116.0 ± 7.0 vs 95.0 ± 9.0 mm Hg, P < .001). The patency rate was 100%, 91.7%, and 85.7% at 1, 3, and 12 months, respectively. The secondary patency rate was 100%. Graft survival was 100% during follow-up. There was no significant deterioration in graft function or BP ( P > .05) postintervention when compared to posttransplantation. Conclusions: Percutaneous intervention for TRAS is safe and results in significant improvement both in allograft function and in BP.


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