Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

Vol. 45 (x): 2019 May 5.[Ahead of print]

doi: 10.1590/S1677-5538.IBJU.2018.0737


ORIGINAL ARTICLE

Alexandre Sallum Bull 1, Affonso Celso Piovesan 1, Giovanni Scala Marchini 1, Kleiton Gabriel Ribeiro Yamaçake 1, Ioannis Michel Antonopoulos 1, Renato Falci 1, Hideki Kanashiro 1, Gustavo Ebaid 1, Francisco César Carnevale 2, Gustavo Messi 1, William Carlos Nahas 1
1 Divisão de Urologia, Unidade de Transplante Renal, Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil; 2 Unidade de Radiologia Intervencionista da Faculdade de Medicina da Universidade de São Paulo – USP, São Paulo, SP, Brasil

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: Transplantation; Kidney; Arteries

[Full Text]


print