Valle Leonardo G M, Cavalcante Rafael N, Motta-Leal-Filho Joaquim M, Affonso Breno B, Galastri Francisco L, Doher Marisa P, Guimarães-Souza Nadia K, Cavalcanti Ana K N, Garcia Rodrigo G, Pacheco-Silva Álvaro, Nasser Felipe
Departamento de Radiologia Intervencionista, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR.
Departamento de Nefrologia, Hospital Israelita Albert Einstein, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2017 Dec;72(12):773-779. doi: 10.6061/clinics/2017(12)09.
To evaluate the safety and efficacy of endovascular intervention with angioplasty and stent placement in patients with transplant renal artery stenosis.
All patients diagnosed with transplant renal artery stenosis and graft dysfunction or resistant systemic hypertension who underwent endovascular treatment with stenting from February 2011 to April 2016 were included in this study. The primary endpoint was clinical success, and the secondary endpoints were technical success, complication rate and stent patency.
Twenty-four patients with transplant renal artery stenosis underwent endovascular treatment, and three of them required reinterventions, resulting in a total of 27 procedures. The clinical success rate was 100%. All graft dysfunction patients showed decreased serum creatinine levels and improved estimated glomerular filtration rates and creatinine levels. Patients with high blood pressure also showed improved control of systemic blood pressure and decreased use of antihypertensive drugs. The technical success rate of the procedure was 97%. Primary patency and assisted primary patency rates at one year were 90.5% and 100%, respectively. The mean follow-up time of patients was 794.04 days after angioplasty.
Angioplasty with stent placement for the treatment of transplant renal artery stenosis is a safe and effective technique with good results in both the short and long term.
评估血管内介入治疗（血管成形术和支架置入术）对移植肾动脉狭窄患者的安全性和有效性。
本研究纳入了2011年2月至2016年4月期间所有被诊断为移植肾动脉狭窄且伴有移植物功能障碍或顽固性系统性高血压并接受支架置入血管内治疗的患者。主要终点是临床成功，次要终点是技术成功、并发症发生率和支架通畅率。
24例移植肾动脉狭窄患者接受了血管内治疗，其中3例需要再次干预，共进行了27次手术。临床成功率为100%。所有移植物功能障碍患者的血清肌酐水平均下降，估算肾小球滤过率和肌酐水平均有所改善。高血压患者的系统性血压控制也得到改善，降压药物的使用减少。该手术的技术成功率为97%。一年时的原发通畅率和辅助原发通畅率分别为90.5%和100%。血管成形术后患者的平均随访时间为794.04天。
血管成形术联合支架置入术治疗移植肾动脉狭窄是一种安全有效的技术，短期和长期效果均良好。
