移植肾动脉狭窄的介入治疗

目的研究移植肾动脉狭窄(TRAS)的临床特点及介入治疗的疗效。方法回顾性分析TRAS患者的临床资料,排除临床资料不完整者,分析总结其临床特点、诊断方法及介入治疗的疗效。结果共搜集病例31例,行介入手术35次。6例行单纯球囊扩张(PTA),24例行支架置入,1例手术失败。术后肾动脉狭窄程度、肾功能及血压明显改善,围手术期未发生严重并发症;平均随访29.6个月,PTA术后2例(33.3%)复发狭窄,行支架置入术无复发;支架术后3例(12.5%)再发狭窄,2例成功行PTA术后无复发。结论肾移植术后密切超声随访有利于早期诊断TRAS,介入治疗TRAS安全、有效且应被视为一线治疗方法。

Endovascular Therapy of Transplant Renal Artery Stenosis

Objective To study the clinical characteristics and the endovascular therapy efficacy of transplant renal artery stenosis(TRAS).Methods Clinical data of patients with TRAS admitted to our hospital from February 2011 to November 2018 were retrospectively analyzed,excluding those with incomplete clinical data.Their clinical characteristics,diagnostic methods and therapeutic effects of endovascular therapy were analyzed and summarized.Results A total of 31 cases were collected and 35 endovascular operations were performed.In this group,6 patients underwent percutaneous transluminal angioplasty(PTA),24 patients underwent stent placement,and 1 patient failed.The degree of renal artery stenosis,renal function and blood pressure were significantly improved after operation,and no serious complications occurred during the perioperative period.The average follow-up period was 29.6 months.Two patients(33.3%)had re-stenosis after PTA,and no recurrence occurred after re-stenting.Three patients(12.5%)had re-stenosis after stenting,and two patients had successful PTA later,without recurrence.Conclusion Close follow-up after kidney transplantation by ultrasound is helpful for early diagnosis of TRAS.Endovasculartherapy of TRAS is safe and effective and should be considered as first-line treatment.