Duplex Doppler sonography of transplant renal artery stenosis

Abstract

Duplex Doppler sonography is an excellent method for screening patients suspected to have TRAS and can help select which of those patients should undergo digital subtraction arteriography.

The Use of Drug-Eluting Stents in the Management of Transplant Renal Artery Stenosis

“…A peak Doppler velocity exceeding 200 cm/s with color aliasing at the site of stenosis with renal to external iliac artery peak velocity ratio exceeding 2 are good indicators of the presence of stenosis (16). Our approach has been to study patients with high suspicion and positive DU Transplant Renal Artery Stenosis studies directly with angiography with appropriate caution to contrast usage.…”

“…The median time in months from transplantation to diagnosis of TRAS was Transplant Renal Artery Stenosis 4.1 (range 1. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Upon presentation, all 12 patients were hypertensive and had allograft dysfunction, more than half (7/12) had dependent edema, and a quarter had a bruit on auscultation.…”

Vascular and nonvascular complications of renal transplants: Sonographic evaluation and correlation with other imaging modalities, surgery, and pathology

“…2,3 Increased velocity of the blood flow (>180-210 cm/sec) in the renal artery at the anastomosis is suggestive of renal artery stenosis ( Figure 2). [3][4][5] Alternatively, it has also been suggested that when the ratio of the flow velocity in the iliac artery to that in the renal artery is greater than 3-3.5:1, renal artery stenosis may be suspected. 6 Renal vein stenosis is uncommon but may be due to compression from perinephric fluid collections or masses.…”

Evaluation of severe transplant renal artery stenosis with Doppler sonography

“…However, the cutoff values of the conventional Doppler parameters for the detection of TRAS, including renal artery PSV, acceleration time, resistance index and Pre-PSV ratio (ratio of the PSV in the renal artery to that in the iliac artery), differ from series to series. 2,[4][5][6][7]10,[12][13][14]16,17 To the best of our knowledge, Post-PSV ratio (ratio of the PSV in the renal artery to that in the interlobar arteries) has not been used in the diagnosis of TRAS. The purpose of this investigation was to evaluate Doppler parameters for the diagnosis of severe TRAS (80%-99% diameter reduction) and to compare Doppler findings in patients with end-to-end and end-to-side anastomosis.…”

“…Doppler sonography has proven to be a good routine imaging modality for diagnosing TRAS because of its relatively high diagnostic accuracy, low cost, non-invasiveness, and lack of irradiation. 2,7 Most previously published reports on the evaluation of TRAS using Doppler sonography have focused on patients with a >50% stenosis. 2,4,7,[8][9][10][11][12][13][14][15][16] Relatively little is known on the diagnosis of severe TRAS 4,16,17 or the evaluation of TRAS of end-to-end anastomosis 8,9,16 using Doppler sonography.…”