Percutaneous transluminal angioplasty of renal transplant arterial stenoses

Renal artery stenosis is a relatively frequent occurrence after renal transplantation. Forty-three hypertensive patients with such a stenosis underwent percutaneous transluminal angioplasty (PTA). The procedure was successful in 35 patients (81%). One month after a primary successful PTA, 74% of patients were improved. Restenosis occurred in seven patients. It was diagnosed in all seven before the fifth post-PTA month. In six patients, repeat PTA was attempted and was successful. One year after successful PTA, 67% of the patients were improved. No complication causing loss of renal parenchyma or needing surgery occurred. PTA is the procedure of choice for relief of transplant renal artery stenosis in patients with hypertension refractory to medical treatment or decline in renal function. It is effective and appears safer than surgery.