TREATMENT OF RENAL GRAFT ARTERY STENOSISCOMPARISON BETWEEN SURGICAL BYPASS AND PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY
作者:
M. Meyer,
Y. Pirson,
J. Dautrebande,
J. Squifflet,
G. Alexandre,
C. van Ypersele de Strihou,
期刊:
Transplantation
(OVID Available online 1989)
卷期:
Volume 47,
issue 5
页码: 784-787
ISSN:0041-1337
年代: 1989
出版商: OVID
数据来源: OVID
摘要:
In order to compare saphenous bypass (SB) and percutaneous transluminal angioplasty (PTA) as treatment of renal graft artery stenosis (GAS), we have reviewed the results of both procedures in 33 patients treated consecutively by either SB (n = 16) or PTA (n = 17). All patients had become hypertensive within the first year after transplantation despite triple hypotensive drug therapy. SB was performed 17 (range 3–55) and PTA 19 (range 2–96) months after transplantation. SB failed in only 1 patient as a result of vascular thrombosis with graft loss. PTA was technically unsuccessful in 3 patients and was complicated by vascular branch thrombosis in 1 patient. Blood pressure decrease was similar in both groups: from 179/114 before SB to 147/90 (n = 15, P<.001) at 6 months and 150/93 (n=14,P<.005) at 12 months after SB and from 177/110 before PTA to 149/93 (n=13,P<.01) at 6 months and 150/95 (n=10,P <.02) at 12 months. At 1 year, control of BP was improved in 85% of SB group patients and 74% of PTA group patients. Recurrent stenosis was documented in 3 PTA group patients: subsequently 1 had a successful SB and the 2 others a repeated PTA—successful in 1, unsuccessful in the other.We conclude that both methods are equally effective for BP control but that PTA entails a higher rate of initial failure and a significant rate of restenosis. However, because of technical ease and better tolerance, PTA emerges as the first-choice treatment of GAS, SB remaining indicated when PTA is not feasible or has failed.
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