MP32-11 PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR TREATMENT OF TRANSPLANT RENAL ARTERY STENOSIS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II1 Apr 2016MP32-11 PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY FOR TREATMENT OF TRANSPLANT RENAL ARTERY STENOSIS Alexander Massmann, C. Marchal, Christina Niklas, Sarah Seiler-Mußler, Urban Sester, Gunnar Heine, G.K. Schneider, Arno Bücker, Michael Stöckle, and Martin Janssen Alexander MassmannAlexander Massmann More articles by this author , C. MarchalC. Marchal More articles by this author , Christina NiklasChristina Niklas More articles by this author , Sarah Seiler-MußlerSarah Seiler-Mußler More articles by this author , Urban SesterUrban Sester More articles by this author , Gunnar HeineGunnar Heine More articles by this author , G.K. SchneiderG.K. Schneider More articles by this author , Arno BückerArno Bücker More articles by this author , Michael StöckleMichael Stöckle More articles by this author , and Martin JanssenMartin Janssen More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1306AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES After kidney transplantation transplant renal artery stenosis (TxRAS) can cause significant morbidity and loss of renal function. To evaluate the percutaneous transluminal angioplasty, a single-center database was studied retrospectively. Perinterventional and functional outcome was recorded to evaluate safety and feasibility. METHODS From Jan 2000 to November 2015, 383 patients recieved a renal transplant, 67/383 after living donation. 66 patients underwent catheter-angiography (n=41 male; mean age and standard deviation 54,8 ±15,1 years). Peri-interventional data, complications and functional data e.g. ultrasound, bloodpressure and GFR were studied. RESULTS TxRAS was detected in 63 patients after a mean of 219 (range 1-891) days after transplantation, and treated by interventional means. The inital technical success (residual stenosis <25%) after stent-placement was 100%. A balloon-mounted CoCr-Stent (Cordis Palmaz Blue) was used in 62 cases, in one patient a ePTFE-coated balloon-mounted stent (Atrium Advanta V12) was placed to protect potential rupture in a patient with a filiforme anastomosis. No peri-interventional complication was recoreded, During a mean follow-up of 35 (21-62) months all functional parameters improved: reduction of arterial systolic and diastolic blood-pressure (given mean, std. dev. and t-test result comparing pre- and post-intervention) pre-interventional systolic RR: 138±12 to post 1-year: 137±5 mmHg (p=0,0233), diastolic RR from pre: 87±12 mmHg, to post 1-year: 77±9 mmHg (p=0.052). The total number of different antihypertensive medication and daily dosing were reduced. A reduction of the accelerated renal arterial flow was recorded: pre 3.1±1.2 m/s to 1.3±0.4 m/s (p=0.0089). The resistence-index improved: pre 0.64 ±0.09 to post 1-year: 0.73 ±0.09 (p=0.0195). Renal function improved after one week: S-creatinine pre: 2.68±1.04 (1.8-5.5) to post 1.99±0.32 (1.6-2.5) mg/dl (p=0.0625), and GFR pre: 31.5±5.1 (23.2-39.1) to post 38.4 ±7.2 (25.8-50.4) (p=0.0309). The primary 1-year patency and graft-survival was 100%. CONCLUSIONS Interventional stent placement is a safe and efficient method for TxRAS treatment improving arterial hypertension, haemodynamics and graft-function. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e432 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Alexander Massmann More articles by this author C. Marchal More articles by this author Christina Niklas More articles by this author Sarah Seiler-Mußler More articles by this author Urban Sester More articles by this author Gunnar Heine More articles by this author G.K. Schneider More articles by this author Arno Bücker More articles by this author Michael Stöckle More articles by this author Martin Janssen More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...