POSTTRANSPLANT RENAL-ARTERY STENOSIS - OUTPATIENT INTRAARTERIAL DSA VERSUS COLOR AIDED DUPLEX DOPPLER SONOGRAPHY

被引：15

作者：

DUDA, SH

ERLEY, CM

WAKAT, JP

HUPPERT, PE

LAUCHART, W

RISLER, T

CLAUSSEN, CD

机构：

[1] Department of Diagnostic Radiology, Eberhard-Karls-University of Tübingen

[2] Section of Hypertension, Nephrology Eberhard-Karls-University of Tübingen

[3] Department of General Surgery, Eberhard-Karls-University of Tübingen

来源：

EUROPEAN JOURNAL OF RADIOLOGY | 1993年 / 16卷 / 02期

关键词：

DIGITAL SUBTRACTION ANGIOGRAPHY; RENAL; KIDNEY; TRANSPLANTATION; RENAL ARTERIES; STENOSIS OR OBSTRUCTION; US STUDIES;

D O I：

10.1016/0720-048X(93)90004-7

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

A prospective trial was conducted to assess the accuracy of color aided duplex Doppler (CADD) sonography to rule out transplant renal artery stenosis (TRAS) and to determine feasibility and safety of intraarterial digital subtraction angiography (DSA) in hypertensive renal allograft recipients on an outpatient basis. All patients were hypertensive (n = 18, mean age: 42 +/- 11 years) and underwent CADD and an i.a. DSA with 4F catheters. There was a 4 hour rest post DSA. Duplex Doppler measurements of maximum velocity were obtained. Absolute values of greater-than-or-equal-to 100 cm/s were considered indicative to suspect TRAS. DSA revealed severe TRAS in 4 patients (22%). The stenoses were located near the iliorenal anastomosis (n = 2) and at the bifurcation of the renal artery (n = 2). Duplex Doppler classified twelve (67 %) renal artery pedicles normal (maximum velocity: 79 +/- 23 cm/s). TRAS was suspected in 6 patients with a maximum velocity of 159 +/- 48 cm/s (P< 0.01). False positive CADD diagnoses were due to tortuous graft vessels and a postbiopsy arteriovenous fistula. Sensitivity of CADD was 100%, specifity 86%. There were no DSA related complications. No impairment of graft function occurred. CADD allows renal angiography to be reserved to clarify an inconclusive ultrasound study and for definite diagnosis of angiomorphology and lesion classification. Intraarterial DSA of renal grafts in out-patients may be performed without an increased risk of procedure-related complications.

引用

页码：95 / 101

页数：7

共 25 条

[1]

Kasiske, Possible causes and consequences of hypertension in stable renal transplant patients, Transplantation, 44, pp. 639-643, (1987)

[2]

Stanley, Malekzadeh, Diament, Posttransplant renal artery stenosis: angiographic study in 32 children, AJR, 148, pp. 487-490, (1987)

[3]

Smith, Dunn, Hypertension in renal parenchymal disease, Hypertension, pp. 1583-1599, (1990)

[4]

Deglise-Favre, Hiesse, Lantz, Moukarzel, Bensadoun, Benoit, Charpentier, Fries, Long-term follow-up of 40 untreated cadaveric kidney transplant renal artery stenoses, Transpl Proc, 23, pp. 1342-1343, (1991)

[5]

Hohnke, Abendroth, Schleibner, Land, Vascular complications in 1200 kidney transplantations, Transpl Proc, 14, pp. 3691-3692, (1987)

[6]

Lacombe, Arterial stenosis complicating renal allotransplantation in man: A study of 38 cases, Ann Surg, 181, pp. 283-288, (1975)

[7]

Gedroyc, Reidy, Saxton, Arteriography of renal transplantation, Clinical Radiology, 28, pp. 239-243, (1987)

[8]

Foley, Bookstein, Tweist, Gikas, Mayor, Turcotte, Arteriography of renal transplants, Radiology, 116, pp. 271-277, (1975)

[9]

Deane, Cairns, Walters, Palmer, Parsons, Roberts, Taube, Diagnosis of renal transplant artery stenosis by color Doppler ultrasonography, Transpl Proc, 22, (1990)

[10]

Kaude, Hawkins, Angiography of renal transplant, Radiol Clin North Am, 14, pp. 295-308, (1976)

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