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移植肾肾动脉狭窄的血管内治疗结果。

Outcomes of endovascular treatment of renal arterial stenosis in transplanted kidneys.

机构信息

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.

出版信息

Int Braz J Urol. 2019 Sep-Oct;45(5):925-931. doi: 10.1590/S1677-5538.IBJU.2018.0737.

Abstract

OBJECTIVE

To evaluate the effectiveness and outcomes of endovascular treatment of TRAS with PTA.

MATERIALS AND METHODS

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.

RESULTS

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%.

CONCLUSIONS

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.

摘要

目的

评估经皮腔内血管成形术(PTA)治疗 TRAS 的效果和结果。

材料和方法

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。

结果

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%。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d8c/6844355/81b1e6c14578/1677-5538-ibju-45-05-0925-gf01.jpg

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