Divisão de Urologia, Unidade de Transplante Renal, Faculdade de Medicina da Universidade de São Paulo - USP, São Paulo, SP, Brasil.
Unidade de Radiologia Intervencionista da Faculdade de Medicina da Universidade de São Paulo - USP, São Paulo, SP, Brasil.
Int Braz J Urol. 2019 Sep-Oct;45(5):925-931. doi: 10.1590/S1677-5538.IBJU.2018.0737.
To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA.
We searched our prospectively collected database looking at cases of TRAS between January 2005-December 2011. CCT was the gold-standart for diagnosis of TRAS. Parameters analysed comprised technical aspects, arterial blood pressure variation, and renal function. A minimum follow-up of 24 months was considered.
Of the 2221 renal transplants performed in the selected period, 22 (0.9%) patients were identifi ed with TRAS. Fourteen (63.6%) were male and mean age was 377±14.8years (12-69). Kidney graft was from deceased donnors in 20 (80%) cases. On doppler evaluation, mean blood fl ow speed after transplantation, at TRAS diagnosis and after TAP was 210.6±99.5, 417±122.7 and 182.5±81.6mL/sec, respectively (p<0.001). For SBP and DBP, there was a signifi cant difference between between preintervention and all post-treatment time points (p<0.001). After 1 month of the procedure, there was stabilization of the Cr level with a signifi cant difference between mean Cr levels along time (p<0.001). After a mean follow-up of 16±4.2 (3-24) months, overall success rate was 100%.
Endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS, ensuring the functionality of the graft and normalization of blood pressure and renal function.
评估经皮腔内血管成形术(PTA)治疗 TRAS 的效果和结果。
我们检索了 2005 年 1 月至 2011 年 12 月期间我们前瞻性收集的数据库中 TRAS 的病例。CCT 是 TRAS 诊断的金标准。分析的参数包括技术方面、动脉血压变化和肾功能。认为至少随访 24 个月。
在所选择的时期内进行的 2221 例肾移植中,发现 22 例(0.9%)患者存在 TRAS。14 例(63.6%)为男性,平均年龄为 377±14.8 岁(12-69 岁)。20 例(80%)肾移植供体来自已故供体。在多普勒评估中,移植后、TRAS 诊断时和 TAP 后平均血流速度分别为 210.6±99.5、417±122.7 和 182.5±81.6mL/sec(p<0.001)。SBP 和 DBP 在干预前和所有治疗后时间点之间存在显著差异(p<0.001)。在手术 1 个月后,Cr 水平稳定,随着时间的推移,Cr 水平差异有统计学意义(p<0.001)。在平均随访 16±4.2 个月(3-24 个月)后,总成功率为 100%。
经皮腔内血管成形术(PTA)/支架置入术是治疗 TRAS 的一种安全有效的选择,可确保移植物的功能以及血压和肾功能的正常化。