血运重建的移植肾动脉狭窄经皮腔内球囊成形术

来源 :华中科技大学 | 被引量 : 0次 | 上传用户:leaffan1985
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Objective:  To assess the technical and clinical outcome of percutaneous transluminal balloon angioplasty and/ or stenting in the management of transplant renal artery stenosis (TRAS).  Methods:  From January, 2011 to July, 2012 four patients underwent a total of 5 endovascular interventions for TRAS at our center. Their medical charts were retrospectively analyzed with particular interest in clinical presentation, time interval from transplant to diagnosis of TRAS, diagnostic evaluation, location of stenosis, treatments, and both technical and clinical outcomes.  Results:  The technical success rate of PTA and/stent placement was 80%(4 of 5). Two PTA’s and 2 PTA/S were primary interventions and 1 PTA/S was subsequently performed due to re-stenosis (three weeks later). The mean follow up was 3 months. The mean pre-procedure serum creatinine level was 2.11 mg/dl, versus the 1-week post-procedure serum creatinine level was1.63 mg/dl, a reduction of 22.75%. The number of anti-hypertension medication remained the same pre and post procedure, but the mean pre-procedure diastolic blood pressure was 99.2mmHg while the post procedure diastolic blood pressure was 81.6mmHg, a reduction of 17.74%. Therefore all patients with successful PTAs and or PTAS attained clinical success. TRAS location was anastomotic in 3 patients, and distal in 1 patient. The patency rates were 92%at 1 month, 84%at 3 months. No complications were encountered.  Conclusions:  Revascularization of TRAS with PTA and/ or stent placement yields good technical outcomes, controls blood pressure and preserves renal function in allograft recipients.
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