title: Transplant renal artery stenosis: The impact of endovascular management and their outcomes.
abstract: BACKGROUND
  Transplant renal artery stenosis (TRAS) is a well-known vascular complication of renal transplantation. The aim of this analysis was to assess the short and midterm outcomes of endovascular therapy to salvage transplant kidney.
  
  
  METHODS
  We retrospectively analyzed our transplant database from 2000 to 2015. Percutaneous transluminal angioplasty/stenting was done in 24 patients (22 men and two women) with significant TRAS. The mean age was 59 ± 12 years. The parameters analyzed were: Technical success, pre- and post-treatment serum creatinine and number of antihypertensive drugs before and after treatment and vessel patency on Doppler ultrasonography at 3 and 6 months.
  
  
  RESULTS
  Overall incidence of TRAS in this study was 5.06%. Incidence of TRAS following live donor transplantation was 4.68% while that in deceased donors was 11.5%. Technical success was 100%. There were no periprocedural deaths. Renal function was improved from 2.32 ± 0.5 mg/dL to 1.72 ± 0.3 mg/dL (P< 0.001) and number of antihypertensive medications after the procedure was reduced from 2.9 ± 0.7 to 2 ± 0.6 (P< 0.001) at 6 months follow-up. One patient developed restenosis within 5 months (4.2%). Clinical success at 6 months follow-up was 79.2%.
  
  
  CONCLUSIONS
  Endovascular treatment of TRAS has high technical success with minimal complications. It also provides satisfactory clinical success with improvement in overall transplant renal function and renovascular hypertension in early follow-up.
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: Avinash Bapusaheb
authors.initials: AB
authors.lastname: Patil
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: D
authors.initials: D
authors.lastname: Ramesh
authors.affiliation: Department of Vascular and Endovascular Surgery, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: Sanjay C
authors.initials: SC
authors.lastname: Desai
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: Prasad
authors.initials: P
authors.lastname: Mylarappa
authors.affiliation: Department of Vascular and Endovascular Surgery, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: Sri Harsha
authors.initials: SH
authors.lastname: Guttikonda
authors.affiliation: Department of Urology, M.S. Ramaiah Hospital, Bengaluru, Karnataka, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Puvvada
keywords: Angioplasty and stenting; endovascular treatment; renovascular hypertension; transplant renal artery stenosis