Revascularization Of Transplant Renal Artery Stenosis By Percutaneous Transluminal Balloon Angioplasty

Objective: To assess the technical and clinical outcome of percutaneoustransluminal balloon angioplasty and/or stenting in the management oftransplant renal artery stenosis (TRAS).Methods: From January,2011to July,2012four patients underwent a total of5endovascular interventions for TRAS at our center. Their medical chartswere retrospectively analyzed with particular interest in clinical presentation,time interval from transplant to diagnosis of TRAS, diagnostic evaluation,location of stenosis, treatments, and both technical and clinical outcomes.Results: The technical success rate of PTA and/stent placement was80%(4of5). Two PTA’s and2PTA/S were primary interventions and1PTA/S wassubsequently performed due to re-stenosis (three weeks later). The meanfollow up was3months. The mean pre-procedure serum creatinine level was2.11mg/dl, versus the1-week post-procedure serum creatinine level was1.63mg/dl, a reduction of22.75%. The number of anti-hypertension medicationremained the same pre and post procedure, but the mean pre-procedurediastolic blood pressure was99.2mmHg while the post procedure diastolicblood pressure was81.6mmHg, a reduction of17.74%. Therefore all patientswith successful PTAs and or PTAS attained clinical success. TRAS locationwas anastomotic in3patients, and distal in1patient. The patency rates were92%at1month,84%at3months. No complications were encountered.Conclusions: Revascularization of TRAS with PTA and/or stent placementyields good technical outcomes, controls blood pressure and preserves renalfunction in allograft recipients.