Spontaneous recanalization of occluded transplant renal artery: a rare case report
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CASE REPORT
Open Access
Spontaneous recanalization of occluded transplant renal artery: a rare case report Xiangjun Dong1,2, Yingliang Wang1,2, Huimin Liang1,2, Chuansheng Zheng1,2, Hui Zhao3, Hong yao Hu3, Xi Long1,2 and Yangbo Su1,2*
Abstract Background: Transplant renal artery stenosis (TRAS) is a serious vascular complication that occurs after renal transplantation and can result in hypertension, renal functional impairment, and graft loss. Endovascular treatment has become the first-line treatment for TRAS because of its low invasiveness and high success rate. Case presentation: A 23-year-old female with end-stage renal disease of unknown cause received a living-donor kidney transplantation 10 months ago. Seven months after the transplantation, her blood pressure gradually deteriorated. Magnetic resonance angiography revealed bending and stenosis of the transplant renal artery, and the patient received endovascular treatment. A digital subtraction angiography revealed significant stenosis of 95% in the proximal transplant renal artery. The guidewire could not pass through the stenotic segment of the transplant renal artery even with repeated attempts by the surgeons; as a result, the transplant renal artery became occluded, and vasodilators were ineffective. After the operation, renal function gradually worsened, so she began to receive regular dialysis. Twenty-five days later, the patient’s urine volume was significantly higher than that before, and ultrasound showed that the proximal transplant renal artery was not completely occluded. A re-intervention was performed, and the stent was placed successfully in the stenotic segment. After the operation, renal function gradually recovered, and dialysis was no longer needed. Conclusion: Patients with iatrogenic transplant renal artery occlusion may have the possibility of spontaneous recanalization, which can help prevent the need for re-transplantation. Keywords: Transplant renal artery stenosis, Kidney transplantation, Endovascular treatment, Stent, Case report
Background Transplant renal artery stenosis (TRAS) is a serious vascular complication that occurs after renal transplantation, and it can result in hypertension, renal functional impairment, and graft loss [1]. The incidence of TRAS is approximately 1 to 23% [2]. Endovascular treatment has become the first-line therapy for TRAS because of its low invasiveness and high success rate [3, 4]. Herein, we report a case of TRAS in which the stenotic segment * Correspondence: [email protected] 1 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China 2 Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China Full list of author information is available at the end of the article
was iatrogenically occluded on the first endovascular treatment attempt, followed by subsequent spontaneous recanalization and successful stent placement.
Case presentation A 23-year-old female with end-stage renal disease of unknown cause received a
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