Mid-term results of endovascular treatment for the transplanted renal arterial stenosis

Abstract

Objective To investigate the safety and mid- term efficacy of percutaneous endovascular angioplasty(PTA) and stent implantation for transplantation renal arterial stenosis(TRAS) . Methods Retrospective analysis was performed on 18 patients with TRAS admitted to of department vascular surgery, PLA General Hospital from Jan 2011 to Dec 2018. Results PTA and stent implantation were performed in all 18 patients via ipsilateral or contralateral femoral artery including 4 cases of PTA alone, 8 cases of PTA plus stent, 6 cases of stent implanted directly.Three of the 18 patients underwent ipsilateral femoral artery catheterization and 15 underwent contralaterally.A total of 14 stents were implanted, all of were balloon expanding stents, of which 2 were drug-coated stents, and the technical success rate was 100%.The average dosage of contrast agent was 64 ml, the stenosis rate of renal artery before interventional treatment was 50%-99%, and that after interventional treatment reduced to 10%-30%.The systolic blood pressure decreased from (157.2±43.0) mmHg preoperatively to (129.8±8.6) mmHg postoperatively.The SCr level decreased from (258.8±214.7) μmol/L to (176.3±101.1) μmol/L. Preoperative urea nitrogen decreased from (15.7±1.6) mmol/L to (10.6±1.1) mmol/L postoperatively (P<0.05). Mean postoperative follow-up time was 42.4 months (3-93 months).17 cases were cured, 1 case was ineffective, 1 case suffered restenosis after 30 days, and was given remedy PTA plus stenting. Conclusions TRAS is a vascular factor leading to grafted renal failure, the endovascular treatment of TRAS is safe, effective and has good mid-term result. Key words: Kidney transplantation; Renal artery obstruction; Angioplasty; Stent