Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys

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 identified 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 flow 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 significant 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 significant 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.