Ces radiol. 2008, 62(2):174-180

Successful restoration of failed renal graft functions after successful angioplasty of pressure resistant renal artery stenosis using cutting balloon: a case reportCase report

Jan H. Peregrin¹, Marcela Burgelová²

¹ Základna radiodiagnostiky a intervenční radiologie, IKEM, Praha

² Klinika nefrologie, IKEM, Praha

This study is a report of 37 year old male with a transplanted kidney. The kidney cadaverous donor was a 3.5 year old child - the graft had two arteries which were transplanted with an aortic patch to an external iliac artery. Four months after transplantation, the graft function was deteriorating together with the development of hypertension. Stenosis of both graft arteries was detected and the patient was referred to angioplasty. The stenoses poorly responded to dilatation and it had to be repeated. Although the completion angiography after second PTRA was not ideal and the smaller of both graft arteries eventually occluded, the graft function improved and was more or less stable (SCr 160-200 μmol/l) for four years along with persistent difficult to control hypertension. Five years after transplantation, the graft function impaired again and a tight graft artery restenosis was detected. The restenosis poorly responded to dilatation, graft function failed, hypertension decompensated and LV failure developed. The patient required dialysis. An attempt to open the artery using a cutting balloon was performed. The angioplasty opened the artery and kidney function was restored after a few days and SCr level dropped to levels 140-160 μmol/l, GFR (CCr) 0.65 ml/s. The graft function has been stable for more than two years, however, the hypertension is still difficult to control.

Keywords: kidney transplantation, graft failure, percutaneous transluminal angioplasty, cutting balloon

Grants and funding:

Práce vznikla za podpory Výzkumného záměru IKEM (grant No. MZO 00023001).

Accepted: March 31, 2008; Published: June 1, 2008  Show citation