Efficacy and safety of Palmaz stent insertion in the treatment of renal artery stenosis in kidney transplantation

Bertoni, E.; Zanazzi, M.; Rosat, Adriá; Piperno, R.; Maria, L. Di; Moscarelli, L.; Salvadori, Maurizio

doi:10.1007/s001470050376

Cited by 18 publications

(16 citation statements)

References 27 publications

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“…We believe that these factors are even more important for the pediatric population, and strongly support PTA as the first-line treatment when an experienced team is available Expandable metallic prostheses have been used for stenosis of coronary, peripheral and renal arteries. Palmaz et al [15] first reported their use in native kidneys and since 1995 several papers reporting their use in RAS have been published [15,16,17,18,19,20]. We have placed a metallic stent in two of our patients.…”

Section: Discussionmentioning

confidence: 82%

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Percutaneous treatment of transplant renal artery stenosis in children

Repetto¹,

Rodríguez-Rilo²,

Mendaro³

et al. 2004

Pediatr Nephrol

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Percutaneous treatment of renal artery stenosis (RAS) is an accepted procedure and numerous reports have been published. However, experience with its use in RAS in the transplanted kidney in children is scarce. Since 1994 we have diagnosed RAS in seven children with the use of Doppler ultrasonography (US), confirming it with percutaneous angiography (PAG). In six of the seven patients percutaneous transluminal angioplasty (PTA) was performed. In one patient a metallic stent was placed due to the extension of the arterial lesion, and a second stent was placed in another child when a re-stenosis was diagnosed 1 month after the PTA. All patients presented with hypertension (de novo or 30% increase over previous values). After ruling out acute rejection, calcineurin inhibitor toxicity, and urinary obstruction, US was performed and, when an increase in arterial flux velocity was registered, PAG was also performed. Six children showed an increase in serum creatinine (Cr) and proteinuria. Blood pressure decreased after the procedure and Cr returned to previous levels in all children. One of the grafts was lost due to chronic transplant rejection 7 years later. The other children have a functioning kidney. Although this is a small group of patients, the consistently good results and the lack of reported experience prompted us to communicate our preliminary observation.

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Section: Discussionmentioning

confidence: 82%

“…The use of expandable metallic prostheses (stents) was reported for coronary, peripheral, and native renal vascular stenosis [15]. Its use in transplant RAS is limited and most papers include only adult patients [16,17,18,19,20,21].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous treatment of transplant renal artery stenosis in children

Repetto¹,

Rodríguez-Rilo²,

Mendaro³

et al. 2004

Pediatr Nephrol

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“…Stents may be useful, especially in those with recurrence [ 56 ]. If there is signifi cant aortoiliac atherosclerotic disease or no response to angioplasty, surgery may be necessary.…”

Section: Treatment Of Trasmentioning

confidence: 98%

Posttransplant diabetes and hypertension: Pathophysiologic insights and therapeutic rationale

Salifu

Tedla²,

Aytug³

et al. 2008

Curr Diab Rep

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New-onset diabetes after transplantation and hypertension are very common after renal transplantation and are associated with adverse graft and cardiovascular outcomes. A thorough understanding of the unique factors that operate in renal transplant recipients is essential for the proper evaluation and management of these important disorders. This review outlines the pathogenesis, diagnostic workup, and therapeutic rationale for diabetes and hypertension after transplantation.

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“…Although stents are not usually required to treat stenoses within the transplant artery or at the anastomosis, they have been used successfully and are needed routinely to treat the pseudo-transplant renal artery stenosis due to iliac atherosclerotic occlusive disease proximal to the takeoff of the transplant artery. 37 Surgical revascularization is reserved for patients in whom angioplasty or stenting has been unsuccessful or complicated. Surgical renal revascularization is difficult and is associated with significant mortality in the transplantation setting.…”

Section: Treatmentmentioning

confidence: 99%