TREATMENT OF RECURRENT TRANSPLANT RENAL-ARTERY STENOSIS WITH METALLICSTENTS

PURPOSE: To evaluate the efficacy of stent deployment in the treatment of recurrent stenosis of transplant renal arteries (TRAs). PATIENTS A ND METHODS: This retrospective study includes six consecutive patients who underwent a mean of 3.66 previous treatments of TRA stenosis per patient before stent implantation (20 ansoplasties and two surgical pr ocedures), The endoprostheses were a Wallstent in four patients and a Palmaz stent in two patients. Clinical, laboratory, and duplex scannin g follow-up was performed every 6 months after stent placement in all patients, RESULTS: The procedure was a technical success in all patien ts, At 6 months, mean systolic blood pressure decreased from 179 to 15 2 mm Hg (P = .018) and mean diastolic blood pressure decreased from 10 2 to 90 mm Hg (P = .09). Mean serum creatinine level dropped from 269 to 182 mmol/L (P = .03) and the number of antihypertensive drugs per p atient decreased from 2.5 to 1.6, At a mean follow-up of 34 months (ra nge, 7-60 months), all TRAs were patent, with a stenosis less than 50% without clinical consequences in one patient. No secondary procedure was necessary. CONCLUSION: Stent placement seems to be an effective tr eatment of TRA recurrent stenosis, Midterm follow-up shows satisfactor y clinical results and TRA patency rates. This technique might be cons idered as a valuable therapeutic option for the treatment of TRA recur rent stenosis.