Iliac artery stenosis after kidney transplantation.
In human kidney transplantation hypertension and renal dysfunction are common complications. Diagnosis of vascular involvement may frequently be necessary. Although iliac artery stenosis is a rare complication after renal transplantation, it can be the cause of hypertension and renal dysfunction. Because colour duplex scanning is a repeatable non-invasive technique, it may provide a useful tool in establishing a diagnosis of iliac artery stenosis in patients with hypertension and/or renal dysfunction. We present four cases of iliac artery stenosis in kidney allograft recipients. Colour duplex scanning was used in these patients to detect and localize the stenosis. Quantitative analysis of Doppler spectra was used to compare the Doppler spectrum waveforms obtained from both femoral arteries and from the kidney allograft arteries of these patients with the normal range. This normal range was determined from Doppler spectra obtained in a control group of 21 kidney allograft recipients. Clinical data, arterial DSA, and the outcome of treatment were used to validate colour duplex findings in the patients with iliac artery stenosis. Quantitative analysis of Doppler spectra showed differences between the femoral artery on the affected side and the contralateral side outside the normal range. In three patients the iliac artery stenosis was located proximal from the anastomosis with the kidney allograft artery and in these three patients Doppler parameters obtained from the allograft artery were also outside the normal range. In one patient the stenosis was located distally from the anastomosis with the kidney allograft artery. In this case Doppler spectra from the kidney allograft artery were within the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)
Merkus
J W
JW
Clinical Vascular Laboratory, University Hospital St Radboud Nijmegen, The Netherlands.
van Asten
W N
WN
Hoitsma
A J
AJ
Buskens
F G
FG
Koene
R A
RA
Skotnicki
S H
SH
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012077:Renal Artery / Q000000981:diagnostic imaging; D014184:Transplantation, Homologous; D014463:Ultrasonography