Short-term efficacy of bare stent placement in the treatment of transplant renal artery stenosis

doi:10.3877/cma.j.issn.2095-5782.2017.02.004

Abstract

Abstract:

Objective:

To explore the short-term efficacy of bare stent placement in the treatment of transplant renal artery stenosis (TRAS).

Methods:

Clinical data of 28 patients with TRAS who were treated in our department between April 2014 and June 2016 were retrospectively analyzed. All patients underwent transplant renal artery bare stent placement after a comprehensive evaluation. The urine volumes before and 7 days after the intervention, systolic blood pressure, diastolic blood pressure, antihypertensive drug dosage, and serum creatinine levels and eGFR before and 1, 3, 6 months after the intervention were compared and analyzed.

Results:

There were significant differences (P <0.01) between the preoperative urine volume and 7 days after intervention. The systolic blood pressure, diastolic blood pressure, serum creatinine levels and eGFR were improved compared to those before the intervention, and the differences were statistically significant (P <0.05). Technical success rate was 100%. Stent patency rates at 1, 3, 6 months after the intervention were 100%, 96.43%, 100%, respectively. Clinical success rate was 96.43% at 6 month, and the chronic rejection of the graft was found in 1 case of bare stent placement. 1 case occurred transplant renal artery restenosis 3 months later, which was significantly improved after balloon expansion.

Conclusion:

Bare stent placement is a safe and effective strategy in the treatment of TRAS with satisfied short-term efficacy.

Key words: Transplant renal artery stenosis, Bare stent placement, Short-term efficacy

Xinling Li, Huan Liu, Kenan Hao, Lijun Xiao, Huajin Pang, Sishen Li, Yaochao Ye, Xiaofeng He. Short-term efficacy of bare stent placement in the treatment of transplant renal artery stenosis[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2017, 05(02): 74-78.

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References 16

1	Shames BD, Odorico JS, D'Alessandro AM, et al. Surgical repair of transplant renal artery stenosis with preserved cadaveric iliac artery grafts[J]. Ann Surg,2003,237(1):116-122.
2	Roberts JP, Ascher NL, Fryd DS, et al. Transplant renal artery stenosis[J]. Transplantation,1989,48(4):580-583.
3	Chen W, Kayler LK, Zand MS, et al. Transplant renal artery stenosis: clinical manifestations, diagnosis and therapy[J]. Clin Kidney J,2015,8(1):71-78.
4	Patil AB, Ramesh D, Desai SC, et al. Transplant renal artery stenosis: The impact of endovascular management and their outcomes[J]. Indian J Urol,2016,32(4):288-292.
5	Spinosa DJ, Isaacs RB, Matsumoto AH, et al. Angiographic evaluation and treatment of transplant renal artery stenosis[J]. Curr Opin Urol, 2001,11(2):197-205.
6	梅雀林，李彦豪，何晓峰，等. 介入治疗移植肾动脉狭窄的疗效观察[J]. 临床放射学杂志,2004，23(11):989-991.doi:10.3969/j.issn.1001-9324.2004.11.017.
7	Fervenza FC, Lafayette RA, Alfrey EJ, et al. Renal artery stenosis in kidney transplants[J]. Am J Kidney Dis,1998,31(1):142-148.
8	Kolli KP, Laberge JM. Interventional management of vascular renal transplant complications[J]. Tech Vasc Interv Radiol,2016,19(3):228-236.
9	Ali A, Mishler D, Taber T, et al. Long-term outcomes of transplant recipients referred for angiography for suspected transplant renal artery stenosis[J]. Clin Transplant,2015,29(9):747-755.
10	Kamali K, Abbasi MA, Behzadi AH, et al. Incidence and risk factors of transplant renal artery stenosis in living unrelated donor renal transplantation[J]. J Ren Care,2010,36(3):149-152.
11	Ngo AT, Markar SR, De Lijster MS, et al. A systematic review of outcomes following percutaneous transluminal angioplasty and stenting in the treatment of transplant renal artery stenosis[J]. Cardiovasc Intervent Radiol,2015,38(6):1573-1588.
12	Leonardou P, Gioldasi S, Pappas P. Transluminal angioplasty of transplanted renal artery stenosis: a review of the literature for its safety and efficacy[J]. J Transplant,2011,2011:693820.
13	Merkus JW, Huysmans FT, Hoitsma AJ, et al. Renal allograft artery stenosis: results of medical treatment and intervention. A retrospective analysis[J]. Transpl Int,1993,6(2):111-115.
14	Su CH, Lian JD, Chang HR, et al. Long-term outcomes of patients treated with primary stenting for transplant renal artery stenosis: a 10-year case cohort study[J]. World J Surg,2012,36(1):222-228.
15	Voiculescu A, Schmitz M, Hollenbeck M, et al. Management of arterial stenosis affecting kidney graft perfusion: a single-centre study in 53 patients[J]. Am J Transplant,2005,5(7):1731-1738.
16	Touma J, Costanzo A, Boura B, et al. Endovascular management of transplant renal artery stenosis[J]. J Vasc Surg,2014,59(4):1058-1065.

时间	收缩压（mmHg）	舒张压（mmHg）	血肌酐（μmol/L）	eGFR（ml/min·1.73m²）
术前	152.46±16.14	87.36±11.99	246.57±199.34	39.81±16.86
术后1个月	135.14±11.40^a	82.82±8.23^a	154.43±59.10^a	60.21±21.87^a
术后3个月	131.00±9.21^a	82.07±6.57^a	138.71±57.10^ab	66.83±19.85^ab
术后6个月	130.10±6.55^a	78.00±6.61^a	130.43±61.40^abc	73.58±24.09^abc
F值	23.299	5.515	6.407	13.729
P值	<0.05	<0.05	<0.05	<0.05

时间	收缩压（mmHg）	舒张压（mmHg）	血肌酐（μmol/L）	eGFR（ml/min·1.73m²）
术前	152.46±16.14	87.36±11.99	246.57±199.34	39.81±16.86
术后1个月	135.14±11.40^a	82.82±8.23^a	154.43±59.10^a	60.21±21.87^a
术后3个月	131.00±9.21^a	82.07±6.57^a	138.71±57.10^ab	66.83±19.85^ab
术后6个月	130.10±6.55^a	78.00±6.61^a	130.43±61.40^abc	73.58±24.09^abc
F值	23.299	5.515	6.407	13.729
P值	<0.05	<0.05	<0.05	<0.05

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