Stenting May Improve Transplant Renal Artery Stenosis Outcomes

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.”

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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

From the May 01, 2017 Issue of Renal and Urology News