Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

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

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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Angiography / methods
  • Angioplasty / methods*
  • Blood Pressure / physiology
  • Child
  • Creatinine / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Renal Artery Obstruction / diagnostic imaging
  • Renal Artery Obstruction / etiology*
  • Renal Artery Obstruction / surgery*
  • Reproducibility of Results
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Creatinine