1. Successful Endovascular Treatment for Very-Late-Onset and Acute Progressive Multiple Transplant Renal Segmental Artery Stenoses: A Case Report.
- Author
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Shoji K, Zen K, Shiotsu Y, Nakamura T, Yanishi K, Ushigome H, Kusaba T, Tamagaki K, and Matoba S
- Subjects
- Acute Disease, Aged, Creatinine blood, Humans, Hypertension blood, Hypertension etiology, Hypertension surgery, Iliac Artery surgery, Kidney blood supply, Kidney surgery, Long Term Adverse Effects blood, Long Term Adverse Effects etiology, Magnetic Resonance Angiography, Male, Middle Aged, Postoperative Complications blood, Postoperative Complications etiology, Renal Artery Obstruction blood, Renal Artery Obstruction etiology, Transplants blood supply, Transplants surgery, Angioplasty, Balloon methods, Kidney Transplantation adverse effects, Long Term Adverse Effects surgery, Postoperative Complications surgery, Renal Artery Obstruction surgery
- Abstract
Purpose: To report the endovascular treatment for acute progressive and very-late-onset multiple segmental small-artery stenoses in transplanted kidney parenchyma presenting with rapidly deteriorating renal function and refractory hypertension in a 65-year-old man., Case Report: Nineteen years ago, the patient received a living renal transplant via end-to-end anastomosis of the right internal iliac artery for kidney failure caused by chronic glomerulonephritis. His transplant renal function (creatinine: 0.9 mg/dL) and blood pressure were stable for 18 years. Then rapid worsening of renal function (creatinine: 2.5 mg/dL) and refractory hypertension occurred. Magnetic resonance angiography and renal angiography showed multiple small segmental artery stenoses in the transplanted kidney. At the 1-month follow-up consultation, total occlusion of 2 branches traversing the inferior pole of the kidney was observed, revealing acute progression of artery stenosis. Balloon angioplasty was successfully performed on those branches; renal function improved (creatinine: 1.3 mg/dL), and blood pressure was sufficiently controlled., Conclusions: This is a rare case that revealed very-late-onset multiple segmental renal artery stenoses with acute progression in the transplant kidney. Even multiple small segmental artery stenoses can reduce transplant renal function in the chronic phase and progress rapidly. Early percutaneous transluminal angioplasty may thus be feasible and important for preventing graft loss., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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