Short-Term Outcomes Using a Drug-Coated Balloon for Transplant Renal Artery Stenosis

Abstract

BackgroundThis study aimed to evaluate the early and mid-term outcomes of drug-coated balloon (DCB) use in patients who underwent intervention for transplant renal artery stenosis (TRAS).Material/MethodsWe retrospectively reviewed the records of TRAS patients who received endovascular therapy with DCB in our institution from March 2016 to January 2017. Statistical analysis of pre-/postoperative levels of serum creatinine (Scr), systolic blood pressure (SBP), and renal artery peak systolic velocities (PSV) were performed.ResultsFourteen patients presenting with TRAS, which were mostly located at the anastomosis (n=9) and transplanted artery proximal portion (n=2), were treated with DCB. Three TRAS patients with in-stent restenosis (ISR) were also included in the series. The procedure technique success rate was 100%. The mean follow-up time was 8.6 months. The Scr level decreased from 481.8 μmol/L (208.5–746.2μmol/L) pre-operation to 154μmol/L (89.1–301.2 μmol/L, p<0.01) at 1 month post-intervention. The SBP varied from 161.4 mmHg (152–173 mmHg) to 144.8 mmHg (136–154 mmHg, p<0.01). Renal artery PSV decreased from 364.1 cm/s (217.6–511.9 cm/s) to 134.9 cm/s (79.8–184.2 cm/s, p<0.01). Eleven patients finished mid-term (>6 months) follow-up. The statistical results were not significant compared to those at 1 month, although they all slightly decreased. No re-intervention was performed.ConclusionsThe endovascular approach to TRAS with DCB was a safe and effective treatment for restore and maintain the artery flow and renal function in short-term follow-up.

Endovascular management of transplant renal artery stenosis: A single‐center retrospective study

“…Several studies have suggested that PTAS provides excellent clinical results and have recommended the use of stenting as an initial treatment for TRAS . However, a study conducted by Li et al showed that drug‐coated balloon alone can also be very effective in restoring blood flow to the graft and maintaining its function. In our experience, if the stenosis is short, linear, or relatively distal from the anastomosis, PTA can also achieve satisfactory results.…”

“…Percutaneous interventional therapy is widely accepted as a viable therapy for TRAS . However, the benefits of endovascular interventional therapy to correct TRAS remain controversial.…”

“…However, the benefits of endovascular interventional therapy to correct TRAS remain controversial. In addition, many studies have reported short‐ or medium‐term efficacy of endovascular intervention . Accordingly, in this study, we retrospectively evaluated the safety and long‐term efficacy of interventional therapy.…”

“…[18][19][20][21][22][23][24][25] Percutaneous interventional therapy is widely accepted as a viable therapy for TRAS. [26][27][28] However, the benefits of endovascular interventional therapy to correct TRAS remain controversial. In addition, many studies have reported short-or medium-term efficacy of endovascular intervention.…”

“…In addition, many studies have reported short-or medium-term efficacy of endovascular intervention. 26,27,29 Accordingly, in this study, we retrospectively evaluated the safety and long-term efficacy of interventional therapy.…”