Endovascular Treatment for Transplant Renal Artery Stenosis: 10 Years' Experience from a Single Center.

IF 2.3 4区医学 Q2 PERIPHERAL VASCULAR DISEASE

Kidney & blood pressure research Pub Date : 2024-01-01 Epub Date: 2024-09-05 DOI:10.1159/000541125

Xibin Pu, Bing Wang, Jun Pan, Xinyu Yu, Wei Dai, Yangyan He

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引用次数: 0

Abstract

Introduction: Transplant renal artery stenosis (TRAS) is a common post-renal transplant complication. Although endovascular treatment is widely used to treat TRAS, previous research has been limited by small sample sizes. This article aimed to present the clinical outcomes of endovascular treatment for TRAS in a large sample.

Methods: Between January 2010 and December 2019, this study included patients with TRAS who were admitted to our center. All patients' clinical symptoms, comorbidities, imaging data, treatment, and follow-up results were reviewed retrospectively.

Results: Seventy two patients participated in this study. The median time between renal transplantation and TRAS was 5.25 months. Out of 72 patients, 55 (76.4%) received balloon dilatation in conjunction with stent deployment, 10 (13.9%) received drug-coated balloon dilatation alone, and 7 (9.7%) received balloon dilatation alone. The median follow-up period was 27 months. Primary patency rates were 100%, 81.8%, 74.5%, 64.6%, and 61.8% at 1, 3, 6, 12, and 24 months. A total of 23 patients were found to have restenosis during follow-up, with 6 (26.1%) requiring reintervention and none remaining restenosis after the second treatment. In the subgroup analysis of the three types of stenosis, patients with transplant renal stenosis at the anastomosis had a significantly higher rate of primary patency. Between endovascular treatments, the primary patency rate, postoperative creatinine clearance, and mean systolic blood pressure did not differ significantly.

Conclusion: Endovascular treatment resulted in favorable short-term patency as well as effective relief of renal dysfunction and renal hypertension in TRAS patients.

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移植肾动脉狭窄的血管内治疗：来自单一中心的十年经验。

目的移植肾动脉狭窄（TRAS）是肾移植后常见的并发症。虽然血管内治疗被广泛用于治疗TRAS，但以往的研究因样本量较小而受到限制。本文旨在介绍大样本血管内治疗 TRAS 的临床结果。方法 2010年1月至2019年12月期间，本研究纳入了本中心收治的TRAS患者。回顾性分析所有患者的临床症状、合并症、影像学资料、治疗和随访结果。结果 72名患者参与了这项研究。肾移植与 TRAS 之间的中位时间为 5.25 个月。在 72 名患者中，55 人（76.4%）在使用支架的同时接受了球囊扩张术，10 人（13.9%）仅接受了药物涂层球囊扩张术，7 人（9.7%）仅接受了球囊扩张术。中位随访期为 27 个月。在 1、3、6、12 和 24 个月时，初次通畅率分别为 100%、81.8%、74.5%、64.6% 和 61.8%。共有 23 名患者在随访期间出现再狭窄，其中 6 人（26.1%）需要再次介入治疗，没有人在第二次治疗后仍出现再狭窄。在三种狭窄类型的亚组分析中，吻合处有移植肾狭窄的患者一次通畅率明显更高。在血管内治疗中，一次通畅率、术后肌酐清除率和平均收缩压没有明显差异。结论血管内治疗可获得良好的短期通畅率，并有效缓解 TRAS 患者的肾功能障碍和肾性高血压。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Kidney & blood pressure research 医学-泌尿学与肾脏学

CiteScore

4.80

自引率

3.60%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal comprises both clinical and basic studies at the interface of nephrology, hypertension and cardiovascular research. The topics to be covered include the structural organization and biochemistry of the normal and diseased kidney, the molecular biology of transporters, the physiology and pathophysiology of glomerular filtration and tubular transport, endothelial and vascular smooth muscle cell function and blood pressure control, as well as water, electrolyte and mineral metabolism. Also discussed are the (patho)physiology and (patho) biochemistry of renal hormones, the molecular biology, genetics and clinical course of renal disease and hypertension, the renal elimination, action and clinical use of drugs, as well as dialysis and transplantation. Featuring peer-reviewed original papers, editorials translating basic science into patient-oriented research and disease, in depth reviews, and regular special topic sections, ''Kidney & Blood Pressure Research'' is an important source of information for researchers in nephrology and cardiovascular medicine.