A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis

Ngo, An; Markar, Sheraz R.; Lijster, Manou S. de; Duncan, Neill; Taube, David; Hamady, Mohamad

doi:10.1007/s00270-015-1134-z

Cited by 55 publications

(88 citation statements)

References 36 publications

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“…Early diagnosis and treatment of TRAS is important for prevention of graft damage and the systemic effects of hypertension. As a consequence of the developments in interventional radiology, operations including endovascular-balloon-angioplasty and stent implantation are more commonly performed treatment modalities [4,5,6,7,8]. Herein, we report an interesting case with transplant renovascular hypertension and ascites, both problems of whom resolved with a successful intervention of renal angioplasty.…”

Section: Introductionmentioning

confidence: 88%

“…Nonetheless, we did not detect any signs of pulmonary oedema in clinical or radiological examination of the patient. TRAS is a vascular complication following renal transplantation, current treatment of which includes approaches of endovascular-balloon-dilation and stent implantation [2,4,7]. Salsamendi et al reported good outcome with endovascular balloon dilation on three patients with TRAS [1].…”

Section: Discussionmentioning

confidence: 99%

“…TRAS may also lead to hypervolemia (oedema, ascites), refractory hypertension, and Pickering syndrome known as flash pulmonary oedema [9]. Although conventional angiography is the gold standard, doppler ultrasound is a commonly preferred tool for early diagnosis [3,4,5]. Early diagnosis and treatment of TRAS is important for prevention of graft damage and the systemic effects of hypertension.…”

Section: Introductionmentioning

confidence: 99%

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Successful Treatment of Resistant Hypertension Associated Ascıtes in a Renal Transplant Patient

2016

Ann Clin Anal Med

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ÖzetTransplante renal arter stenozu (TRAS) renal arter lümen çapında % 50'den fazla daralma, böbrek parankiminde hipoperfüzyon, glomerüler filtrasyonda azalma ve plazma kreatinin konsantrasyonlarında yükselmeye olarak tanımlanmak-tadır. Güncel tedavisinde endovasküler-balon-anjiyoplasti ve stent yerleştirilme-si gibi işlemler daha çok uygulanmaktadır. Bu yazıda renovasküler hipertansiyonla birlikte assiti olan ve başarılı endovasküler balon dilatasyonu ile düzelen olgu ilginç bulunduğu için sunuldu. Böbrek naklinden beş ay sonra kan basıncı180/110 mmHg, karında assit, kreatinin: 1.69 mg / dL, ayrıca akciğer grafisinde pulmoner ödem bulgusu olmayan ve diğer laboratuvar testleri normal olan 52 yaşında-ki kadın hastada renal arter anostmoz hattında % 80 darlık tesbit edildi. Darlık endovasküler-balon dilatasyon ile % 10'a düşürüldü. İşlemi takiben, arteriyel kan basıncı normal sınırlara döndü ve ultrasonda assitin tamamen kaybolduğu görül-dü. Transplante renal arter stenozu (TRAS) gelişen olgularda minimal invaziv bir girişim olan endovasküler-balon-dilatasyonu güncel, başarılı ve kolay uygulanabilmesi bakımından geçerli bir tedavi yöntemidir. Anahtar KelimelerRenovasküler Hipertansiyon; Renal Arter Darlığı; Balon Dilatasyonu Abstract Transplante renal artery stenosis (TRAS) is defined as renal artery diameter reduction of more than 50%, which causes a reduction in glomerular filtration rate and a rise in plasma creatinine concentration. Current treatments are endovascularballoon-angioplasty and stent implantation. We present the case with renal artery stenosis and ascites was treated with endovascular-balloon-dilatation. A 52-yearold female patient who was admitted to the nephrology clinic five months after the transplantation with blood pressure: 180/110 mmHg, ascites , and the chest radiograph did not show a pulmonary oedema, creatinine: 1.69 mg/dL other laboratory tests were normal. An occlusion of 80 % in a segment and the stenosis was reduced to 10 % by endovascular-balloon dilation. Following endovascular-balloon dilation, arterial blood pressure were normal and no ascites. Endovascular balloon dilation is minimally invasive method that is also successful, contemporary and valid procedures with easy applicability for the management of TRAS.

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Section: Introductionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful Treatment of Resistant Hypertension Associated Ascıtes in a Renal Transplant Patient

2016

Ann Clin Anal Med

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“…Comorbidities associated with TRAS include diabetes mellitus, hypertension, hyperlipidaemia and smoking 3. Proposed causes include donor or recipient artery atheroma, arterial trauma during procurement or transplantation, different suture techniques with end-to-end anastomosis being more liable to error, immune-mediated vascular damage, prolonged cold ischaemia time and rarely extrinsic mechanical compression 1.…”

Section: Descriptionmentioning

confidence: 99%

Resistant hypertension after kidney transplantation

Callus

Bugeja²,

Delicata³

et al. 2017

BMJ Case Reports

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“…The recurrence rate of TRAS after PTA is very high, and the subsequent management in this setting remains elusive, with some authors advocating intervention with PTA with endovascular stenting and others recommending a more conservative approach. 13 In our center, 3-dimensional computed tomography (3DCT) reconstruction has been used for patients at high risk of TRAS. To examine the application value of 3DCT reconstruction in kidney transplant recipients, we retrospectively reviewed all cases suspicious of TRAS.…”

Section: Introductionmentioning

confidence: 99%

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Zhang

Wang²,

Liu³

et al. 2017

Exp Clin Transplant

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Objectives: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. Materials and Methods: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomog raphy reconstruction and were treated with endo vascular approaches or medically managed. Results: Ten patients were diagnosed with transplant renal artery stenosis by 3-dimensional computed tomography reconstruction. No evidence of contrastinduced nephrotoxicity was observed. Nine of the 10 patients underwent percutaneous transluminal angio plasty, whereas the remaining patient was treated conservatively. Procedural success rate was 100%. Patients were followed for a mean period of 20 ± 3 months. Blood pressure improved from a mean of 163/90 to 132/73 mm Hg at the end of the follow-up period. In the 9 patients who underwent angioplasty, serum creatinine improved from 198 ± 24 to 134 ± 16 µmol/L at the end of the follow-up period. The cystatin C level in some patients declined after interventional therapy. Conclusions: Three-dimensional computed tomography reconstruction is a safe choice for patients who present with increased serum creatinine levels and refractory hypertension. Percutaneous transluminal angioplasty is the preferred therapeutic technique for transplant renal artery stenosis.

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A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis

Cited by 55 publications

References 36 publications

Successful Treatment of Resistant Hypertension Associated Ascıtes in a Renal Transplant Patient

Successful Treatment of Resistant Hypertension Associated Ascıtes in a Renal Transplant Patient

Resistant hypertension after kidney transplantation

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