Endovascular management of transplant renal artery stenosis: A single-center retrospective study
Endovascular management of transplant renal artery stenosis: A single-center retrospective study
复制标题
移植肾动脉狭窄的血管内治疗：单中心回顾性研究
DOI：
10.1002/ccd.28624
复制
发表时间：
2019-12-05
影响因子：
2.3
通讯作者：
Zheng, Chuansheng
中科院分区：
文献类型：
--
作者：
Ren, Yanqiao;Xiong, Fu;Zheng, Chuansheng
目的探讨经皮腔内血管成形术（PTA）/支架置入术治疗移植肾动脉狭窄（TRAS）的疗效及并发症。研究背景TRAS是一种比较少见的疾病，目前对TRAS的介入治疗研究还不够。方法2011年4月至2018年7月，对33例TRAS患者进行介入治疗。参数分析如下：技术成功，治疗前和治疗后血清肌酐，血压，以及治疗后1个月、6个月和12个月以及此后每年一次超声检查的血管通畅性。结果1例手术失败。PTA/支架置入成功率为97.0%。14例PTA（16枚支架）为初次介入治疗，随后因再狭窄进行了2例支架手术;再狭窄率为6.3%。在随访期间，2例患者进展为移植肾衰竭，3例患者失访。其余患者移植肾功能和血压稳定。与术前相比，血压和血清肌酐显著降低（p <0.05）。未发生治疗相关死亡或严重并发症。结论PTA/支架术是治疗TRAS安全有效的方法。对于选定的TRAS患者，PTA或PTA加支架可获得良好的治疗结局。选择合适的穿刺途径有助于提高穿刺成功率，影响手术效果，可避免开放手术。
Objectives The aim is to evaluate the efficacy and complications of percutaneous transluminal angioplasty (PTA)/stenting in the treatment of transplant renal artery stenosis (TRAS). Background TRAS is a relatively rare condition, and currently, there is not enough study about interventional therapy for TRAS. Methods Between April 2011 and July 2018, 33 patients with TRAS underwent interventional therapy. Analysis of parameters was as follows: technical success, pretreatment and posttreatment serum creatinine, and blood pressure, and vessel patency via ultrasound at 1, 6, and 12 months posttreatment and once a year thereafter. Results One procedure failed. The success rate of PTA/stenting placement was 97.0%. Fourteen PTAs with 16 stents were primary interventions, with 2 stent procedures performed subsequently due to restenosis; the restenosis rate was 6.3%. During the follow-up period, two patients progressed to graft renal failure and three patients were lost to follow-up. The rest of the patients still had stable graft function and blood pressure. Compared with preoperative conditions, blood pressure and serum creatinine significantly decreased (p < .05). No treatment-related deaths or serious complications occurred. Conclusions PTA/stenting is a safe and effective treatment for TRAS. For selected TRAS patients, PTA or PTA with stent may achieve good therapeutic outcomes. Selecting appropriate puncture pathways may help improve the success rate and affect the operation results, and open surgery may be avoided.