PURPOSE: To assess the outcome of percutaneous transluminal angioplasty (PTA) and stent placement as the primary treatment for transplant renal artery stenosis (TRAS). MATERIALS AND METHODS: A retrospective review of PTA and stent placement procedures performed for TRAS from April 1997 to July 2003 was conducted. Reviewed parameters included technical success, date of transplantation, dates of percutaneous intervention, mean arterial blood pressure, number of blood pressure medications, and serum creatinine level before and after intervention. Twenty-one interventions were performed in 18 allografts. The primary clinical indication for imaging and treatment was increased creatinine level in 12 allografts and hypertension in six allografts. Patency rates were estimated with use of the Kaplan-Meier method. RESULTS: The technical success rate of PTA/stent placement was 100% and the clinical success rate was 94% (17 of 18 allografts). Thirteen interventions involved PTA alone, with eight combined PTA and stent insertions. The mean preintervention serum creatinine level among 12 allografts presenting with elevated creatinine levels was 2.8 mg/dL +/- 1.4 (SD), compared with a 1-month postintervention mean of 2.2 mg/dL +/- 0.7 (P = .03). Of six allografts that presented with hypertension, significant improvement was seen between the preintervention and 1-month postintervention mean systolic (174 mm Hg vs 135 mm Hg, P = .003) and diastolic (99 mm Hg vs 82 mm Hg, P = .02) pressures. These patients required a mean of 2.3 medications for blood pressure control before intervention, compared with a mean of 1.0 medications at 1 month after intervention (P = .002). Primary patency rates at 3, 6, and 12 months (+/-95% CI) were 94% +/- 6%, 72% +/- 12%, and 72% +/- 12%, respectively. Secondary patency rates at 3, 6, and 12 months (+/-95 CI) were 100%, 85% +/- 10%, and 85% +/- 10%, respectively. Mean follow-up time was 27 months. Of the eight allografts that underwent stent placement, all eight remained patent at last follow-up (mean, 18.3 months +/- 9.2). One major complication of a puncture site pseudoaneurysm occurred (5%). CONCLUSION: Primary treatment of TRAS with PTA with or without stent placement has good intermediate-term patency and is associated with significant early improvement in blood pressure and creatinine level.
PURPOSE: To assess the outcome of percutaneous transluminal angioplasty (PTA) and stent placement as the primary treatment for transplant renal artery stenosis (TRAS). MATERIALS AND METHODS: A retrospective review of PTA and stent placement procedures performed for TRAS from April 1997 to July 2003 was conducted. Reviewed parameters included technical success, date of transplantation, dates of percutaneous intervention, mean arterial blood pressure, number of blood pressure medications, and serum creatinine level before and after intervention. Twenty-one interventions were performed in 18 allografts. The primary clinical indication for imaging and treatment was increased creatinine level in 12 allografts and hypertension in six allografts. Patency rates were estimated with use of the Kaplan-Meier method. RESULTS: The technical success rate of PTA/stent placement was 100% and the clinical success rate was 94% (17 of 18 allografts). Thirteen interventions involved PTA alone, with eight combined PTA and stent insertions. The mean preintervention serum creatinine level among 12 allografts presenting with elevated creatinine levels was 2.8 mg/dL +/- 1.4 (SD), compared with a 1-month postintervention mean of 2.2 mg/dL +/- 0.7 (P = .03). Of six allografts that presented with hypertension, significant improvement was seen between the preintervention and 1-month postintervention mean systolic (174 mm Hg vs 135 mm Hg, P = .003) and diastolic (99 mm Hg vs 82 mm Hg, P = .02) pressures. These patients required a mean of 2.3 medications for blood pressure control before intervention, compared with a mean of 1.0 medications at 1 month after intervention (P = .002). Primary patency rates at 3, 6, and 12 months (+/-95% CI) were 94% +/- 6%, 72% +/- 12%, and 72% +/- 12%, respectively. Secondary patency rates at 3, 6, and 12 months (+/-95 CI) were 100%, 85% +/- 10%, and 85% +/- 10%, respectively. Mean follow-up time was 27 months. Of the eight allografts that underwent stent placement, all eight remained patent at last follow-up (mean, 18.3 months +/- 9.2). One major complication of a puncture site pseudoaneurysm occurred (5%). CONCLUSION: Primary treatment of TRAS with PTA with or without stent placement has good intermediate-term patency and is associated with significant early improvement in blood pressure and creatinine level.
Authors: Alexander Copelan; Daniel George; Baljendra Kapoor; Hahn Vu Nghiem; Jonathan M Lorenz; Brian Erly; Weiping Wang Journal: Semin Intervent Radiol Date: 2015-06 Impact factor: 1.513
Authors: Maria Koukoulaki; Elias Brountzos; Ioannis Loukopoulos; Maria Pomoni; Eleni Antypa; Vasileios Vougas; Spiros Drakopoulos Journal: World J Transplant Date: 2015-06-24
Authors: Matthew R Weir; Ellen D Burgess; James E Cooper; Andrew Z Fenves; David Goldsmith; Dianne McKay; Anita Mehrotra; Mark M Mitsnefes; Domenic A Sica; Sandra J Taler Journal: J Am Soc Nephrol Date: 2015-02-04 Impact factor: 10.121
Authors: G Guzzardi; R Fossaceca; I Di Gesù; P Cerini; M Di Terlizzi; C Stanca; E Malatesta; D Moniaci; P Brustia; P Stratta; A Carriero Journal: Radiol Med Date: 2012-10-22 Impact factor: 3.469