Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis
Abstract Background Endovascular treatment is standard of care for transplant renal artery stenosis (TRAS). No study has evaluated long-term outcomes compared between percutaneous transluminal renal angioplasty (PTRA) and PTRA with stenting (PTRAS). Accordingly, this study aimed to investigate the 1...
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-021-02015-4 |
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| author | Nattawut Wongpraparut Thunyarat Chaipruckmalakarn Thongtum Tongdee Archan Jaspttananon Attapong Vongwiwatana Nalinee Premasathian Kawin Anusonadisai Rungtiwa Pongakasira |
| author_facet | Nattawut Wongpraparut Thunyarat Chaipruckmalakarn Thongtum Tongdee Archan Jaspttananon Attapong Vongwiwatana Nalinee Premasathian Kawin Anusonadisai Rungtiwa Pongakasira |
| author_sort | Nattawut Wongpraparut |
| collection | DOAJ |
| description | Abstract Background Endovascular treatment is standard of care for transplant renal artery stenosis (TRAS). No study has evaluated long-term outcomes compared between percutaneous transluminal renal angioplasty (PTRA) and PTRA with stenting (PTRAS). Accordingly, this study aimed to investigate the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in patients diagnosed with TRAS at Thailand’s largest national tertiary referral center. Methods This single-center retrospective study included kidney transplant patients treated for TRAS during January 2001 to June 2019. Clinical success was defined as (1) increase in estimated glomerular filtration rate (eGFR) > 15%, or (2) reduction in mean arterial pressure (MAP) > 15% with no decrease in antihypertensive medication, or no reduction in MAP or reduction in MAP < 15% with decrease in antihypertensive medication. Incidence of kidney transplant graft failure and transplant renal artery stenosis were also collected. Results Sixty-five cases of TRAS were identified from 1072 patients who underwent kidney transplantation. The majority (98.5%) had end-to-side anastomosis technique. Thirty-four patients had PTRA, while 31 patients had PTRAS. One-year clinical success according to renal outcome and BP reduction was 78.5% and 49.2%, respectively. Both renal outcome (79.4% vs. 77.4%, p = 0.845) and BP reduction (40.6% vs. 58.1%, p = 0.166) at 1 year were similar between the PTRA and PTRAS groups. Compared between PTRA and PTRAS, event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher for PTRAS at 1 year (82.4% vs. 100%, p = 0.025), but not significantly different at 10 years (73.5% vs. 71%, p = 0.818). Conclusions We demonstrated the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in TRAS patients. One-year clinical success was found to be similar between groups. Event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher in PTRAS at 1 year, but similar between groups at 10 years. Trial registration Thai Clinical Trials Registry, TCTR20200626002. Registered 26 June 2020—Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trial search&smenu = fulltext&task = search&task2 = view1&id = 6441 |
| first_indexed | 2024-12-17T08:38:31Z |
| format | Article |
| id | doaj.art-0ef16e6945f2459ab21c4cb5720ece8a |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-17T08:38:31Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
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| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-0ef16e6945f2459ab21c4cb5720ece8a2022-12-21T21:56:25ZengBMCBMC Cardiovascular Disorders1471-22612021-04-012111910.1186/s12872-021-02015-4Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosisNattawut Wongpraparut0Thunyarat Chaipruckmalakarn1Thongtum Tongdee2Archan Jaspttananon3Attapong Vongwiwatana4Nalinee Premasathian5Kawin Anusonadisai6Rungtiwa Pongakasira7Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityInterventional Radiology Unit, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Nephrology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityDivision of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol UniversityHer Majesty’s Cardiac Center, Faculty of Medicine Siriraj Hospital, Mahidol UniversityAbstract Background Endovascular treatment is standard of care for transplant renal artery stenosis (TRAS). No study has evaluated long-term outcomes compared between percutaneous transluminal renal angioplasty (PTRA) and PTRA with stenting (PTRAS). Accordingly, this study aimed to investigate the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in patients diagnosed with TRAS at Thailand’s largest national tertiary referral center. Methods This single-center retrospective study included kidney transplant patients treated for TRAS during January 2001 to June 2019. Clinical success was defined as (1) increase in estimated glomerular filtration rate (eGFR) > 15%, or (2) reduction in mean arterial pressure (MAP) > 15% with no decrease in antihypertensive medication, or no reduction in MAP or reduction in MAP < 15% with decrease in antihypertensive medication. Incidence of kidney transplant graft failure and transplant renal artery stenosis were also collected. Results Sixty-five cases of TRAS were identified from 1072 patients who underwent kidney transplantation. The majority (98.5%) had end-to-side anastomosis technique. Thirty-four patients had PTRA, while 31 patients had PTRAS. One-year clinical success according to renal outcome and BP reduction was 78.5% and 49.2%, respectively. Both renal outcome (79.4% vs. 77.4%, p = 0.845) and BP reduction (40.6% vs. 58.1%, p = 0.166) at 1 year were similar between the PTRA and PTRAS groups. Compared between PTRA and PTRAS, event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher for PTRAS at 1 year (82.4% vs. 100%, p = 0.025), but not significantly different at 10 years (73.5% vs. 71%, p = 0.818). Conclusions We demonstrated the 1-year clinical success, and short- and long-term event-free survival between PTRA and PTRAS in TRAS patients. One-year clinical success was found to be similar between groups. Event-free survival for composite of kidney transplant graft failure or transplant renal artery restenosis was significantly higher in PTRAS at 1 year, but similar between groups at 10 years. Trial registration Thai Clinical Trials Registry, TCTR20200626002. Registered 26 June 2020—Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trial search&smenu = fulltext&task = search&task2 = view1&id = 6441https://doi.org/10.1186/s12872-021-02015-4Percutaneous transluminal renal angioplasty (PTRA)Percutaneous transluminal renal angioplasty with stenting (PTRAS)Transplant renal artery stenosis (TRAS)Long-term outcome |
| spellingShingle | Nattawut Wongpraparut Thunyarat Chaipruckmalakarn Thongtum Tongdee Archan Jaspttananon Attapong Vongwiwatana Nalinee Premasathian Kawin Anusonadisai Rungtiwa Pongakasira Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis BMC Cardiovascular Disorders Percutaneous transluminal renal angioplasty (PTRA) Percutaneous transluminal renal angioplasty with stenting (PTRAS) Transplant renal artery stenosis (TRAS) Long-term outcome |
| title | Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis |
| title_full | Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis |
| title_fullStr | Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis |
| title_full_unstemmed | Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis |
| title_short | Long-term outcome of percutaneous transluminal renal angioplasty (PTRA) versus PTRA with stenting (PTRAS) in transplant renal artery stenosis |
| title_sort | long term outcome of percutaneous transluminal renal angioplasty ptra versus ptra with stenting ptras in transplant renal artery stenosis |
| topic | Percutaneous transluminal renal angioplasty (PTRA) Percutaneous transluminal renal angioplasty with stenting (PTRAS) Transplant renal artery stenosis (TRAS) Long-term outcome |
| url | https://doi.org/10.1186/s12872-021-02015-4 |
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