Treatment of recurrent transplant renal artery stenosis with metallic stents.
OBJECTIVE
To evaluate the efficacy of stent deployment in the treatment of recurrent stenosis of transplant renal arteries (TRAs).


METHODS
This retrospective study includes six consecutive patients who underwent a mean of 3.66 previous treatments of TRA stenosis per patient before stent implantation (20 angioplasties and two surgical procedures). The endoprostheses were a Wallstent in four patients and a Palmaz stent in two patients. Clinical, laboratory, and duplex scanning follow-up was performed every 6 months after stent placement in all patients.


RESULTS
The procedure was a technical success in all patients. At 6 months, mean systolic blood pressure decreased from 179 to 152 mm Hg (P = .018) and mean diastolic blood pressure decreased from 102 to 90 mm Hg (P = .09). Mean serum creatinine level dropped from 269 to 182 mmol/L (P = .03) and the number of antihypertensive drugs per patient decreased from 2.5 to 1.6. At a mean follow-up of 34 months (range, 7-60 months), all TRAs were patent, with a stenosis less than 50% without clinical consequences in one patient. No secondary procedure was necessary.


CONCLUSIONS
Stent placement seems to be an effective treatment of TRA recurrent stenosis. Midterm follow-up shows satisfactory clinical results and TRA patency rates. This technique might be considered as a valuable therapeutic option for the treatment of TRA recurrent stenosis.
Sierre
S D
SD
Department of Cardiovascular Radiology, Broussais Hospital, Paris, France.
Raynaud
A C
AC
Carreres
T
T
Sapoval
M R
MR
Beyssen
B M
BM
Gaux
J C
JC
D000328:Adult; D000792:Angiography; D000800:Angioplasty, Balloon / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006978:Hypertension, Renovascular / Q000000981:diagnostic imaging / Q000628:therapy; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000628:therapy*; D012008:Recurrence; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome