Short-Term Outcomes Using a Drug-Coated Balloon for Transplant Renal Artery Stenosis

BACKGROUND This study aimed to evaluate the early and mid-term outcomes of drug-coated balloon (DCB) use in patients who underwent intervention for transplant renal artery stenosis (TRAS). MATERIAL AND METHODS We retrospectively reviewed the records of TRAS patients who received endovascular therapy with DCB in our institution from March 2016 to January 2017. Statistical analysis of pre-/postoperative levels of serum creatinine (Scr), systolic blood pressure (SBP), and renal artery peak systolic velocities (PSV) were performed. RESULTS Fourteen patients presenting with TRAS, which were mostly located at the anastomosis (n=9) and transplanted artery proximal portion (n=2), were treated with DCB. Three TRAS patients with in-stent restenosis (ISR) were also included in the series. The procedure technique success rate was 100%. The mean follow-up time was 8.6 months. The Scr level decreased from 481.8 µmol/L (208.5-746.2µmol/L) pre-operation to 154µmol/L (89.1-301.2 µmol/L, p<0.01) at 1 month post-intervention. The SBP varied from 161.4 mmHg (152-173 mmHg) to 144.8 mmHg (136-154 mmHg, p<0.01). Renal artery PSV decreased from 364.1 cm/s (217.6-511.9 cm/s) to 134.9 cm/s (79.8-184.2 cm/s, p<0.01). Eleven patients finished mid-term (>6 months) follow-up. The statistical results were not significant compared to those at 1 month, although they all slightly decreased. No re-intervention was performed. CONCLUSIONS The endovascular approach to TRAS with DCB was a safe and effective treatment for restore and maintain the artery flow and renal function in short-term follow-up.