ENDOLUMINAL STENT PLACEMENT AFTER PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN THE TREATMENT OF POSTTRANSPLANT RENAL-ARTERY STENOSIS

Purpose: We report our experience with endoluminal stent placement aft er percutaneous transluminal angioplasty for the treatment of post-tra nsplant renal artery stenosis. Materials and Methods: From October 199 2 to September 1996, 8 stents were successfully implanted in 7 patient s affected by resistant transplant renal artery stenosis. All transpla nted kidneys were procured from cadaver donors. The patients were rout inely evaluated with duplex sonography and the median interval between transplantation and stenosis detection was 7.4 months (range 0.5 to 1 7). When serious renal stenosis was diagnosed (greater than 50%), sele cted angiography and percutaneous transluminal angioplasty were perfor med. In 8 cases (7 patients) an endoluminal metallic Palmaz stent was placed in the site of the restenosis. One patient received 2 stents re peatedly positioned in different stenosis sites. Results: No major com plications occurred. Clinical outcome was positive in 5 patients (71.4 %) and Stenosis recurred in 2 (28.5%) (less than 50% and less than 35% , respectively). Median followup after stent placement was 14.8 months (range 1 to 37). Conclusions: Percutaneous endoluminal stent procedur es after resistant transplant renal artery stenosis or for ex novo tre atment for severe anastomotic stenoses appears to be promising. Longer followup periods are necessary for true evaluation of this procedure.