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. 2019 Sep-Oct;45(5):925-931.
doi: 10.1590/S1677-5538.IBJU.2018.0737.

Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

Alexandre Sallum Bull  1 , Affonso Celso Piovesan  1 , Giovanni Scala Marchini  1 , Kleiton Gabriel Ribeiro Yamaçake  1 , Ioannis Michel Antonopoulos  1 , Renato Falci  1 , Hideki Kanashiro  1 , Gustavo Ebaid  1 , Francisco César Carnevale  2 , Gustavo Messi  1 , William Carlos Nahas  1
Affiliations

Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

Alexandre Sallum Bull et al. Int Braz J Urol. 2019 Sep-Oct.

Abstract

Objective: To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA.

Materials and methods: We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS. Parameters analysed comprised technical aspects, arterial blood pressure variation, and renal function. A minimum follow-up of 24 months was considered.

Results: Of the 2221 renal transplants performed in the selected period, 22 (0.9%) patients were identifi ed with TRAS. Fourteen (63.6%) were male and mean age was 377±14.8years (12-69). Kidney graft was from deceased donnors in 20 (80%) cases. On doppler evaluation, mean blood fl ow speed after transplantation, at TRAS diagnosis and after TAP was 210.6±99.5, 417±122.7 and 182.5±81.6mL/sec, respectively (p<0.001). For SBP and DBP, there was a signifi cant difference between between preintervention and all post-treatment time points (p<0.001). After 1 month of the procedure, there was stabilization of the Cr level with a signifi cant difference between mean Cr levels along time (p<0.001). After a mean follow-up of 16±4.2 (3-24) months, overall success rate was 100%.

Conclusions: Endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS, ensuring the functionality of the graft and normalization of blood pressure and renal function.

Keywords: Arteries; Kidney; Transplantation.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Three-dimensional reconstruction of arteriography showing TRAS due to kinking (A). Arteriography evidenciating successful outcome after stent placement at the kinking site (B).
Figure 2
Figure 2. Systolic and diastolic blood pressure curves before and after TRAS treatment with TAP.
Figure 3
Figure 3. Curve progress of creatinine levels after PTA/stenting.
Figure 4
Figure 4. Comparison of creatinine progress regarding the site and cause of anastomosis. Data with mean+-Standard Deviation.
See this image and copyright information in PMC

References

    1. 1. Bruno S, Remuzzi G, Ruggenenti P. Transplant renal artery stenosis. J Am Soc Nephrol. 2004;15:134-41. - PubMed
    2. Bruno S, Remuzzi G, Ruggenenti P. Transplant renal artery stenosis. J Am Soc Nephrol. 2004;15:134–141. - PubMed
    1. 2. Fervenza FC, Lafayette RA, Alfrey EJ, Petersen J. Renal artery stenosis in kidney transplants. Am J Kidney Dis. 1998;31:142-8. - PubMed
    2. Fervenza FC, Lafayette RA, Alfrey EJ, Petersen J. Renal artery stenosis in kidney transplants. Am J Kidney Dis. 1998;31:142–148. - PubMed
    1. 3. Roberts JP, Ascher NL, Fryd DS, Hunter DW, Dunn DL, Payne WD, et al. Transplant renal artery stenosis. Transplantation. 1989;48:580-3. - PubMed
    2. Roberts JP, Ascher NL, Fryd DS, Hunter DW, Dunn DL, Payne WD, et al. Transplant renal artery stenosis. Transplantation. 1989;48:580–583. - PubMed
    1. 4. Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, et al. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953-62. - PubMed
    2. Wheatley K, Ives N, Gray R, Kalra PA, Moss JG, Baigent C, et al. Revascularization versus medical therapy for renal-artery stenosis. N Engl J Med. 2009;361:1953–1962. - PubMed
    1. 5. Henning BF, Kuchlbauer S, Böger CA, Obed A, Farkas S, Zülke C, et al. Percutaneous transluminal angioplasty as first-line treatment of transplant renal artery stenosis. Clin Nephrol. 2009;71:543-9. Erratum in: Clin Nephrol. 2009;72:82. - PubMed
    2. Henning BF, Kuchlbauer S, Böger CA, Obed A, Farkas S, Zülke C, et al. Percutaneous transluminal angioplasty as first-line treatment of transplant renal artery stenosis. Clin Nephrol. 2009;71:543–549. Erratum in: Clin Nephrol. 2009;72:82. - PubMed

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