Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Jun 24, 2015; 5(2): 68-72
Published online Jun 24, 2015. doi: 10.5500/wjt.v5.i2.68
Successful endovascular treatment of transplant intrarenal artery stenosis in renal transplant recipients: Two case reports
Maria Koukoulaki, Elias Brountzos, Ioannis Loukopoulos, Maria Pomoni, Eleni Antypa, Vasileios Vougas, Spiros Drakopoulos
Maria Koukoulaki, Ioannis Loukopoulos, Eleni Antypa, Vasileios Vougas, Spiros Drakopoulos, Transplant Unit, Evangelismos General Hospital of Athens, 10676 Athens, Greece
Elias Brountzos, Maria Pomoni, Research Unit of Radiology and Medical Imaging, Eugenideion Hospital, University of Athens, 11141 Athens, Greece
Author contributions: Koukoulaki M, Loukopoulos I, Vougas V and Drakopoulos S designed the report; Brountzos E, Pomoni M and Antypa E performed the radiologic assessment and procedures; Koukoulaki M, Loukopoulos I, Vougas V and Drakopoulos S collected the patient’s clinical data; Koukoulaki M and Loukopoulos I analyzed the data and wrote the paper.
Ethics approval: Ethics approval was not required.
Informed consent: Informed consent was obtained prior to initiation of procedure.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Maria Koukoulaki, MD, MPhil (Cantab), PhD, Transplant Unit, Evangelismos General Hospital of Athens, 45-47 Ipsilantou street, 10676 Athens, Greece. mkoukoulaki@gmail.com
Telephone: +30-210-7233422 Fax: +30-210-7233421
Received: October 29, 2014
Peer-review started: October 31, 2014
First decision: November 14, 2014
Revised: February 2, 2015
Accepted: March 18, 2015
Article in press: March 20, 2015
Published online: June 24, 2015
Processing time: 233 Days and 14.7 Hours
Abstract

Transplant renal artery stenosis (TRAS) is a relatively rare complication after renal transplantation. The site of the surgical anastomosis is most commonly involved, but sites both proximal and distal to the anastomosis may occur, as well. Angioplasty is the gold standard for the treatment of the stenosis, especially for intrarenal lesions. We report two cases of intrarenal TRAS and successful management with angioplasty without stent placement. Both patients were male, 44 and 55 years old respectively, and they presented with elevated blood pressure or serum creatinine within three months after transplantation. Subsequently, they have undergone angioplasty balloon dilatation with normalization of blood pressure and serum creatinine returning to baseline level. Percutaneous transluminal balloon renal angioplasty is a safe and effective method for the treatment of the intrarenal TRAS.

Keywords: Transplant renal artery stenosis; Intrarenal stenosis; Hypertension; Renal transplantation; Allograft dysfunction; Angioplasty; Endovascular treatment

Core tip: Transplant renal artery stenosis is a relatively rare complication after renal transplantation and usually affects the site of the surgical anastomosis. Intrarenal stenosis is rather uncommon, manifesting with uncontrolled hypertension and rise in serum creatinine. Angioplasty is the gold standard for the treatment of the stenosis, especially for intrarenal lesions.