Interventional treatment of transplanted renal artery stenosis / 介入放射学杂志

ABSTRACT

Objective To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3 - 18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20 ～ 30 mm) and / or small balloon catheters (2. 6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75% ～ 98% pre-PTA to 10% ～ 30% post-PTA.Systolic pressure decreased from 170 mmHg (150 ～ 210 mmHg) pre-PTA to 135 mmHg (100 - 190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90 - 145 mmHg) to 85 mmHg (80 - 125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n = 11) , melioration (n = 15), improvement (n = 7), and inefficiency (n = 2) after follow - up of 23 months (3 - 60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter.Reasonable use of stents is beneficial in decreasing the restenosis.