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Successful Endovascular Treatment for Very-Late-Onset and Acute Progressive Multiple Transplant Renal Segmental Artery Stenoses: A Case Report.
- Source :
-
Transplantation proceedings [Transplant Proc] 2021 May; Vol. 53 (4), pp. 1262-1267. Date of Electronic Publication: 2020 Dec 01. - Publication Year :
- 2021
-
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.<br />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.<br />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.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 53
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 33272651
- Full Text :
- https://doi.org/10.1016/j.transproceed.2020.09.022