2:24 PM; Abstract No. 256 - Renal transplant arterial stenosis treated with BMS vs DES stents: comparison of short term treatment outcomes

Abstract

Our study aim was to evaluate outcomes of bare metal stents (BMS) versus drug eluting stents (DES) in patients who undergo stenting for renal transplant arterial stenosis. We retrospectively reviewed records of renal transplant patients who underwent an IR procedure from September 2009 to September 2013 to identify those who underwent transplant arterial stenting. Because DES are only available in small diameters, all stents greater than 5 mm were excluded to allow for equivalent comparison between the two groups. Stenting indications were reviewed and recorded. Statistical comparisons were performed using a two tailed Fischer’s exact test. Renal transplant arterial stenting was performed in 35 of 133 renal transplant patients who underwent an IR procedure. Of these, 18 received stents of 5 mm or smaller, 11 BMS and 7 DES, and were included in the final study population. Patients included 12 with rising creatinine, one with elevated blood pressure, four with elevated velocities/resistive indices on Doppler ultrasound, and one with two causes. Post-stenting, one BMS patient underwent re-stenting, three angioplasty, and seven required no re-intervention; in DES, zero, zero, and seven, respectively. There were more reinterventions with BMS (n=4/11) than DES (n=0/7) but not statistically significant (p=0.12). In BMS, two of five patients on dialysis recovered renal function after stenting; in DES, zero of three (p=0.19). Conversely, in BMS, one of six patients not on dialysis before stenting never improved and required dialysis; in DES, zero of four (p=1.0). Our 4 year records comparing patients with renal transplant arterial BMS versus DES of 5 mm or smaller diameter reveal that there is an absolute but not statistically significant difference in the incidence of restenosis requiring repeat intervention between the two groups. However, this may be due to our small sample size. Future larger studies will be needed to corroborate these findings.