title: 5 Years Experience With Drug Eluting and Bare Metal Stents as Primary Intervention in Transplant Renal Artery Stenosis.
abstract: BACKGROUND
  Transplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation and is associated with refractory hypertension, volume overload, and graft injury or loss. This article describes 5-year outcomes of endovascular intervention for TRAS with bare metal and drug eluting stents (DES).
  
  
  METHODS
  We investigated, as a prospective cohort study, patient and graft outcomes after the targeted use of DES for vessel diameter less than 5 mm and bare metal stents (BMS) for vessel diameter greater than 5 mm as the primary management for TRAS.
  
  
  RESULTS
  From March 2008 to November 2014, 57 patients were stented for hemodynamically significant TRAS; 29 received DES, 26 received BMS, and 2 patients received both stent types. They were followed up for a mean of 35.1 ± 22.8 months; a subset of these patients who all received DES were followed up for 61.7 ± 17.5 months. Mean serum creatinine declined from 2.87 ± 1.5 mg/dL at the time of intervention to 1.98 ± 0.76 mg/dL (P< 0.001) at one month follow-up and was 1.96 ±0.92 mg/dL (P< 0.001) at 35.1 ± 22.8 months. Mean systolic blood pressure declined from 159.05 ± 19.68 mm Hg at time of intervention to 135.65 ± 15.10 mm Hg (P< 0.001) at most recent visit. Clinically driven restenosis requiring repeat revascularization occurred in 15.7% of patients.
  
  
  CONCLUSIONS
  Primary stenting with DES and BMS is both successful in the initial treatment of TRAS and also produced an immediate and long-term reduction in serum creatinine and systolic blood pressure.
authors.affiliation: Divisions of Nephrology, Department of Medicine, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Chelsea C
authors.initials: CC
authors.lastname: Estrada
authors.affiliation: Division of Cardiology, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Muzammil
authors.initials: M
authors.lastname: Musani
authors.affiliation: Division of Transplantation, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Frank
authors.initials: F
authors.lastname: Darras
authors.affiliation: Divisions of Nephrology, Department of Medicine, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Heesuck
authors.initials: H
authors.lastname: Suh
authors.affiliation: Divisions of Nephrology, Department of Medicine, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Mersema T
authors.initials: MT
authors.lastname: Abate
authors.affiliation: Division of Cardiology, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Anil
authors.initials: A
authors.lastname: Mani
authors.affiliation: Divisions of Nephrology, Department of Medicine, Stony Brook Medicine, Stony Brook, NY.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Nord