Interventional treatment of transplanted renal artery stenosis

Objective: To evaluate the treatment of transplanted renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA)and stentplacement. Methods: The averange time from transplantation to the symptom occurrence of TRAS was 5.5 months (4-15 months)in 12 TRAS patients. All of them received the interventional therapy through femoral approach. Average BP, creatinine level and stenosis before and after the procedure were taken as the judgement standards. Results: PTA was performed with balloon (length 20 - 40 mm, diameter 5 - 7 mm) in 4 patients, stenting after PTA in 5, including 3 of direct stenting. Two cases (17%)occurred restenosis after PTA and restenting was undertaken. Three ases (25%) with restenosis after stentplacement were undergone PTA. One self-expandable stent and 9 balloon-dilatation stent were released in 10 cases. Stenosis significantly decreased from 65% - 95% preoperatively to 15% - 25% postoperatively, together with average BP decreased from 175/105 mmHg to 140/80 mmHg and creatinine level decreased from 475.5 μmol/L to 118.5 μmol/L. Among 12 cases included 4 healed, melioration (5), improvement (2), and inefficiency (1)during follow-up of 9 months (3 - 24 months). No complication occurred. Conclusion: The interventional therapy is effective and safe for TRAS with high rates of procedure success and efficacy. The proper selection of the adapted approach combined with PTA and stenting may effectively raise the long term efficacy for TRAS and success rate of the procedure.