Department of General Surgery, Haiyan People's Hospital, Hangzhou, China.
Department of Vascular Surgery, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.
Kidney Blood Press Res. 2024;49(1):821-830. doi: 10.1159/000541125. Epub 2024 Sep 5.
Transplant renal artery stenosis (TRAS) is a common post-renal transplant complication. Although endovascular treatment is widely used to treat TRAS, previous research has been limited by small sample sizes. This article aimed to present the clinical outcomes of endovascular treatment for TRAS in a large sample.
Between January 2010 and December 2019, this study included patients with TRAS who were admitted to our center. All patients' clinical symptoms, comorbidities, imaging data, treatment, and follow-up results were reviewed retrospectively.
Seventy two patients participated in this study. The median time between renal transplantation and TRAS was 5.25 months. Out of 72 patients, 55 (76.4%) received balloon dilatation in conjunction with stent deployment, 10 (13.9%) received drug-coated balloon dilatation alone, and 7 (9.7%) received balloon dilatation alone. The median follow-up period was 27 months. Primary patency rates were 100%, 81.8%, 74.5%, 64.6%, and 61.8% at 1, 3, 6, 12, and 24 months. A total of 23 patients were found to have restenosis during follow-up, with 6 (26.1%) requiring reintervention and none remaining restenosis after the second treatment. In the subgroup analysis of the three types of stenosis, patients with transplant renal stenosis at the anastomosis had a significantly higher rate of primary patency. Between endovascular treatments, the primary patency rate, postoperative creatinine clearance, and mean systolic blood pressure did not differ significantly.
Endovascular treatment resulted in favorable short-term patency as well as effective relief of renal dysfunction and renal hypertension in TRAS patients.
移植肾动脉狭窄（TRAS）是肾移植后的一种常见并发症。虽然血管内治疗广泛用于治疗 TRAS，但以前的研究受到样本量小的限制。本文旨在介绍大样本中血管内治疗 TRAS 的临床结果。
本研究纳入 2010 年 1 月至 2019 年 12 月期间在我院就诊的 TRAS 患者。回顾性分析所有患者的临床症状、合并症、影像学资料、治疗及随访结果。
72 例患者参与本研究。TRAS 发生在肾移植后 5.25 个月。72 例患者中，55 例（76.4%）接受球囊扩张联合支架置入术，10 例（13.9%）接受药物涂层球囊扩张术，7 例（9.7%）接受单纯球囊扩张术。中位随访时间为 27 个月。1、3、6、12 和 24 个月时的初始通畅率分别为 100%、81.8%、74.5%、64.6%和 61.8%。随访期间共发现 23 例患者存在再狭窄，其中 6 例（26.1%）需要再次介入治疗，第二次治疗后无再狭窄。在三种狭窄类型的亚组分析中，吻合口处的移植肾狭窄患者初始通畅率明显较高。在血管内治疗之间，初始通畅率、术后肌酐清除率和平均收缩压无显著差异。
血管内治疗可为 TRAS 患者带来良好的短期通畅率，并有效缓解肾功能不全和肾性高血压。
