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Endovascular treatment of transplanted renal artery stenosis with PTA/stenting

Trattamento endovascolare delle stenosi delle arterie renali trapiantate mediante PTA/stenting

  • Vascular and Interventional Radiology / Radiologia Vascolare e Interventistica
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the effectiveness of endovascular treatment with percutaneous transluminal balloon angioplasty (PTA)/stenting of transplanted renal artery stenosis (TRAS).

Materials and methods

Between January 2005 and December 2010, 17 patients (4 women, 13 men; mean age 60.9 years) with TRAS underwent PTA/stenting. The parameters analysed were: technical success, pre- and post-treatment serum creatinine (SCr) and blood pressure (BP), average number of antihypertensive drugs administered before and after treatment and vessel patency on colour Doppler ultrasound (CDUS) at 1, 3, 6 and 12 months and once a year thereafter.

Results

Technical success was 100%. During a mean follow-up of 28.3±18.7 months, there was a statistically significant reduction in SCr and BP values. In 18 % of cases, moderate (<60%) restenosis was observed on CDUS without renal failure and not requiring new treatment. There was a reduction in antihypertensive drugs from an average of 3.5±0.5 to 1.5±0.5.

Conclusions

Consistent with the literature data, our experience shows that endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS and can thus be considered the method of choice.

Riassunto

Obiettivo

Scopo del nostro lavoro è stato valutare l’efficacia del trattamento endovascolare mediante angioplastica percutanea transluminale (PTA)/stenting delle stenosi dell’arteria renale trapiantata (TRAS).

Materiali e metodi

Da gennaio 2005 a dicembre 2010, 17 pazienti (4 femmine e 13 maschi; età media 60,9 anni) affetti da TRAS sono stati sottoposti a PTA/stenting. È stato valutato il successo tecnico della procedura e sono stati confrontati i valori di creatininemia e di pressione arteriosa, il numero di farmaci anti-ipertensivi somministrati prima e dopo il trattamento e la pervietà del vaso trattato mediante eco-color Doppler (ECD) a 1, 3, 6, 12 mesi e successivamente una volta l’anno.

Risultati

Il successo tecnico è stato del 100%; ad un followup medio di 28,3±18,7 mesi, si è osservata una riduzione statisticamente significativa dei valori di creatinina sierica e di pressione arteriosa. All’ECD nel 18% dei casi si è riscontrata re-stenosi di grado moderato (<60%), non associata ad alterazioni della funzionalità d’organo e non meritevole di nuovo trattamento. Si è passati da una assunzione di 3,5±0,5 farmaci anti-ipertensivi a 1,5±0,5.

Conclusioni

Nella nostra esperienza, in linea con i dati della letteratura, il trattamento endovascolare mediante PTA/stenting rappresenta una opzione sicura ed efficace nella gestione delle TRAS, costituendo la prima scelta terapeutica.

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Authors and Affiliations

  1. SCDU Radiodiagnostica e Radiologia Interventistica, A.O.U. Maggiore della Carità, C.so Mazzini 18, 28100, Novara, Italy

    G. Guzzardi, R. Fossaceca, I. Di Gesù, P. Cerini, M. Di Terlizzi, C. Stanca, E. Malatesta & A. Carriero

  2. SCDO Chirurgia Vascolare, A.O.U. Maggiore della Carità, Novara, Italy

    D. Moniaci & P. Brustia

  3. SCDU Nefrologia e Trapianto Renale, A.O.U. Maggiore della Carità, Novara, Italy

    P. Stratta

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  1. G. Guzzardi
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  2. R. Fossaceca
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  3. I. Di Gesù
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Correspondence to G. Guzzardi.

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Guzzardi, G., Fossaceca, R., Di Gesù, I. et al. Endovascular treatment of transplanted renal artery stenosis with PTA/stenting. Radiol med 118, 826–836 (2013). https://doi.org/10.1007/s11547-012-0884-8

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  • DOI: https://doi.org/10.1007/s11547-012-0884-8

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