Chun-meng Li, Tao Shang, Lu Tian, Hong-kun Zhang
(Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland))
Ann Transplant 2018; 23:75-80
This 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 AND METHODS: We 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.
RESULTS: Fourteen 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.
CONCLUSIONS: The 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.
Keywords: Angioplasty, endovascular procedures, Kidney Transplantation, Renal Artery Obstruction