Stenting May Improve Transplant Renal Artery Stenosis Outcomes

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Angioplasty plus stenting is associated with less residual stenosis and a lower restenosis rate compared with angioplasty alone.
Angioplasty plus stenting is associated with less residual stenosis and a lower restenosis rate compared with angioplasty alone.
The following article is part of conference coverage from the 2017 American Transplant Congress (ATC) in Chicago, Illinois. Renal and Urology News' staff will be reporting breaking news associated with research conducted by leading experts in transplantation. Check back for the latest news from ATC 2017. 

Stenting of transplant renal artery stenosis (TRAS) is associated with less residual stenosis compared with angioplasty alone and may result in lower restenosis rates, according to study findings presented at the 2017 American Transplant Congress in Chicago.

Ling-Xin Chen, MD, MS, and colleagues at the UC Davis Medical Center in Sacramento conducted a retrospective single-center cohort study that included 82 kidney transplant recipients who underwent percutaneous angiography (PTA) for TRAS. Of these patients, 58 underwent PTA alone and 24 underwent PTA with stenting. The stented patients had significantly less residual stenosis post-intervention compared with the angioplasty group (7.6% vs 15.8%). Restenosis occurred in a significantly greater proportion of patients in the PTA-only group than the stent group (28% vs 9%).

Repeat angiography was performed for 8 patients (14%) in the PTA-only group and 3 (13%) in the stent group. The groups had similar serum creatinine and blood pressure values at 30, 90, and 360 days post intervention and had similar rates of complications, graft failure and patient death.

“This study indicates that stenting of TRAS may be superior to angioplasty in preventing stenosis recurrence, though there was no detectable clinically relevant improvement in the stented group,” Dr Chen told Renal & Urology News.  “The study is limited by its retrospective nature, and since current practices vary widely between and within institutions, a clinical trial is needed to establish the best treatment approach for TRAS.

Visit Renal and Urology News' conference section for continuous coverage from ATC 2017. 

Reference

Chen LX, Fananapazir G, Bang H, et al. Angioplasty versus stent in the treatment of transplant renal artery stenosis.[abstract]. Am J Transplant 2017;17 (suppl 3). Poster presented at the 2017 American Transplant Congress in Chicago, April 29-May 3. Abstract B138

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