Li Chun-Meng, Shang Tao, Tian Lu, Zhang Hong-Kun
Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
Ann Transplant. 2018 Jan 26;23:75-80. doi: 10.12659/aot.906658.
BACKGROUND This study aimed to evaluate the early and mid-term outcomes of drug-coated balloon (DCB) use in patients who underwent intervention for transplant renal artery stenosis (TRAS). MATERIAL AND METHODS We retrospectively reviewed the records of TRAS patients who received endovascular therapy with DCB in our institution from March 2016 to January 2017. Statistical analysis of pre-/postoperative levels of serum creatinine (Scr), systolic blood pressure (SBP), and renal artery peak systolic velocities (PSV) were performed. RESULTS Fourteen patients presenting with TRAS, which were mostly located at the anastomosis (n=9) and transplanted artery proximal portion (n=2), were treated with DCB. Three TRAS patients with in-stent restenosis (ISR) were also included in the series. The procedure technique success rate was 100%. The mean follow-up time was 8.6 months. The Scr level decreased from 481.8 µmol/L (208.5-746.2µmol/L) pre-operation to 154µmol/L (89.1-301.2 µmol/L, p<0.01) at 1 month post-intervention. The SBP varied from 161.4 mmHg (152-173 mmHg) to 144.8 mmHg (136-154 mmHg, p<0.01). Renal artery PSV decreased from 364.1 cm/s (217.6-511.9 cm/s) to 134.9 cm/s (79.8-184.2 cm/s, p<0.01). Eleven patients finished mid-term (>6 months) follow-up. The statistical results were not significant compared to those at 1 month, although they all slightly decreased. No re-intervention was performed. CONCLUSIONS The endovascular approach to TRAS with DCB was a safe and effective treatment for restore and maintain the artery flow and renal function in short-term follow-up.
背景 本研究旨在评估药物涂层球囊（DCB）用于移植肾动脉狭窄（TRAS）患者介入治疗的早期和中期疗效。材料与方法 我们回顾性分析了2016年3月至2017年1月在我院接受DCB血管内治疗的TRAS患者的记录。对术前/术后血清肌酐（Scr）、收缩压（SBP）和肾动脉收缩期峰值流速（PSV）水平进行统计学分析。结果 14例TRAS患者接受了DCB治疗，病变大多位于吻合口（n = 9）和移植动脉近端部分（n = 2）。该系列还包括3例支架内再狭窄（ISR）的TRAS患者。手术技术成功率为100%。平均随访时间为8.6个月。干预后1个月时，Scr水平从术前的481.8µmol/L（208.5 - 746.2µmol/L）降至154µmol/L（89.1 - 301.2µmol/L，p<0.01）。SBP从161.4 mmHg（152 - 173 mmHg）降至144.8 mmHg（136 - 154 mmHg，p<0.01）。肾动脉PSV从364.1 cm/s（217.6 - 511.9 cm/s）降至134.9 cm/s（79.8 - 184.2 cm/s，p<0.01）。11例患者完成了中期（>6个月）随访。与1个月时相比，统计结果虽均略有下降但无统计学意义。未进行再次干预。结论 在短期随访中，DCB血管内治疗TRAS是恢复和维持动脉血流及肾功能的一种安全有效的治疗方法。
