Angiografia rotacional com reconstrução tridimensional (3D-RA) como ferramenta diagnóstica em pacientes com estenose da artéria do rim transplantado

Abstract

Tridimensional Rotational Angiography (3D-RA) as a Diagnostic Tool for Patients with Transplant Renal Artery Stenosis Background: Transplant renal artery stenosis (TRAS) is the major vascular complication associated to adverse events in patients with kidney grafts, whose incidence ranges from 1% to 23%. Angiography is the gold-standard for diagnosis, enabling immediate treatment; however, due to the variable anatomy and location of anastomosis, additional projections are often required, leading to greater exposure to contrast medium and radiation. Tridimensional rotational angiography (3D-RA) appears as a tool for diagnosis and treatment of TRAS. The aim of this paper was to evaluate the accuracy of measurements obtained by 3D-RA in comparison to conventional angiography. Methods: From April, 2010 to January, 2011, 41 3D-RAs were performed in patients with clinical suspicion of TRAS. Images were analyzed by independent observers; conventional angiography measurements were obtained online and 3D-RA measurements were obtained offline with the Philips Allure 3D-RA software. Results: Thirty-five 3D-RAs (84%) were considered adequate for angiographic measurements, and 20% provided additional and relevant information for the therapeutic strategy. There was no statistically significant difference between measurements obtained from the reference diameter and minimal luminal diameter of the artery using 3D-RA and conventional angiography. In addition, there was a strong correlation between them. Conclusions: 3D-RA comes up as a useful tool for TRAS

Dissecção causando estenose de artéria de rim transplantado: diagnóstico por angiografia rotacional tridimensional

“…A angiografia da artéria renal é o padrão de referência, permitindo a quantificação das dimensões da artéria e do estreitamento luminal, bem como a medida do gradiente de pressão. 8,9 A angiografia tridimensional rotacional demonstrou resultados promissores na radiologia e na neurologia intervencionista, e, recentemente, Souza et al 3 relataram a experiência da Universidade Federal de São Paulo/Unifesp (São Paulo, SP) com a AR-3D na avaliação da estenose de artéria de rim transplantado.…”

Retrospective analysis of percutaneous intervention of the renal artery in transplanted kidneys in children and adolescents at a tertiary public hospital

“…The secondary results were collected after 1 year. As the majority of the patients in the study are regularly assessed in this specialized center, and the long-term follow-up exposed more adverse events as well as benefits of clinical treatment compared with short-term follow-up [3,22,24]. Indeed, another limitation of this study is the small sample size due to the fact that it is a specific population (pediatric population).…”

“…The organ preservation time was 30 (VAT/min) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) in the TRAS group (intervention) and 29 (23.25-32.25) in the control group, with no significant difference between them (p = 0.703).…”