Role of 3D CT-angiography in Detecting Transplant Renal Artery Stenosis.
- Author:
Su Hyun KIM
1
;
Hojung AN
;
Su Jin MOON
;
Jin Young KIM
;
Sun Cheol PARK
;
Ho Jong CHUN
;
Bum Soon CHOI
;
In Sung MOON
;
Chul Woo YANG
;
Yong Soo KIM
;
Byung Kee BANG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. yangch@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Transplant renal artery stenosis;
Hypertension
- MeSH:
Angiography;
Angioplasty;
Arterial Pressure;
Blood Pressure;
Constriction, Pathologic;
Diagnosis;
Female;
Humans;
Hypertension;
Kidney Transplantation;
Mass Screening;
Phenobarbital;
Renal Artery Obstruction*;
Renal Artery*;
Stents;
Transplantation;
Ultrasonography
- From:The Journal of the Korean Society for Transplantation
2007;21(1):88-93
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Transplant renal artery stenosis (TRAS) is a potentially treatable complication of kidney transplantation. Color doppler ultrasound (doppler US) is recommended as primary diagnostic method, but it has some limitations. METHODS: We analyzed with 3D computed tomography angiography (3D-CTA) compared doppler US in the diagnosis of TRAS. Eleven transplant recipients (4 women, 7 men) with new developed or uncontrolled hypertension underwent 3D-CTA. We compared 3D-CTA with the dopper US in all TRAS recipients diagnosed 3D-CTA (n=6). RESULTS: The median age at transplantation was 42 year (Range: 27~55 year), mean systolic blood pressure +/-SD was 163+/-9.9 mmHg and median HLA mismatch was 2 (0~4). The 3D-CTA showed significant TRAS (>70% luminal narrowing) in six recipients. Most commonly stenosis occurred at the anastomotic site (anastomic site, 4; pre-anastomotic 1; diffuse 1 recipients). The dopper US showed suspected TRAS in four recipients but no evidence of TRAS in two recipients. But these all patients showed significant stenosis (>70% luminal narrowing) of transplant renal artery by the percutaneous angiography. All six TRAS recipients successfully were treated by primary percutaneous angioplasty and endovascular stenting. Arterial blood pressure showed significantly improvement after post-endovascualr therapy (Presystolic, 170+/-8 mmHg; postsystolic, 151+/-16 mmHg; P=0.012 and prediastolic, 104+/-4; postdiastolic 92+/-8; P=0.007). CONCLUSION: The 3D-CTA is highly accurate and noninvasive screening test for detecting TRAS than dopper US.
