PERCUTANEOUS TRANSLUMINAL DILATION IN RENAL TRANSPLANT ARTERIAL STENOSIS

Abstract

Hypertensive patients [12] underwent percutaneous transluminal dilation (PTD) for relief of arterial stenosis complicating renal allotransplantation. Two patients underwent repeat PTD for recurrent stenosis and hypertension; 6 had end-to-end anastomosis of the donor renal artery to the recipient hypogastric artery; 4 of 6 PTD were successful. Six patients had end-to-side anastomosis of the donor renal artery to the recipient external iliac artery; 7 of 8 PTD, including 1 of 2 repeat PTD, were successful. Prior to PTD, all patients were using several antihypertensive medications. Following successful PTD, the mean blood pressure dropped from 184 .+-. 15/118 .+-. 9 to 133 .+-. 13/89 .+-. 11 mm Hg (P < 0.001) and remained at that level for up to 15 mo. (average followup 9 mo.) with decreased or no antihypertensive medications. Since surgical correction of arterial stenosis occurring after renal transplantation is difficult and may endanger the graft, PTD should be the 1st interventional therapy.