ENDOVASCULAR TREATMENT OF STENOSIS RENAL VEIN AND FALSE ARTERY ANEURYSM KIDNEY TRANSPLANT (CLINICAL CASE)
DOI:
https://doi.org/10.47390/3030-3133V2I1Y2024N04Keywords:
renal transplant, nephrobiopsy, renal vein stenosis, false aneurysm.Abstract
Kidney transplantation, which significantly improves the quality of life of patients with end-stage chronic renal failure (ESRD) worldwide, is considered one of the important achievements of modern medicine. Vascular complications after kidney transplantation, including stenoses and arterial aneurysms, occur in 1.5-5% of cases, and many of them can now be successfully corrected using endovascular techniques such as balloon angioplasty, stent implantation and selective embolization, which helps to prolong the life of the kidney transplant. This article describes the clinical case of a young patient who successfully underwent endovascular correction of renal vein stenosis (with angioplasty and stent placement) and embolization of a false aneurysm of a renal graft artery that arose after a puncture biopsy. Thanks to the combined approach of specialists, it was possible to preserve the function of the kidney graft. The described clinical case with the presence of stenosis in the renal vein of the graft and a false aneurysm after biopsy in the late post-transplant and post-puncture period is an extremely rare phenomenon. The use of endovascular methods for the correction of vascular complications after kidney transplantation and biopsy allows organ-preserving procedures to be performed in a number of clinical situations, which is critically important for recipient patients.
References
Liu H, Ren L, Fan B, et al. Artificial Intelligence Algo-rithm-Based MRI in the Diagnosis of Complications after Renal Transplantation. Contrast Media Mol Imaging. 2022: 8930584. https://doi.org/10.1155/2022/8930584
Khubutia MSh, Pinchuk AV, Shmarina NV, et al. Vascular complications after kidney transplantation. Bulletin of Transplantology and Artificial Organs. 2013; 15(4): 31-39 [In Russ].
Zilinska Z, Chrastina M, Trebaticky B, et al. Vascular complications after renal transplantation. Bratis/LekListy. 2010; 111(11): 586-589.
Soy EHA, AkdurA, Kirnap M, et al. Vascular Complications After Renal Transplant: A Single-Center Experience. Exp Clin Transplant. 2017; 15(Suppl 1): 79-83. https://doi.org/10.6002/ect.mesot2016.065
Fedoruk AM. Ultrasound images of surgical complications of kidney transplantation (review). Surgery. Eastern Europe. 2017; 6(4): 588-600 [In Russ].
Kolli KP, LaBerge JM. Interventional Management of Vascular Renal Transplant Complications.Tech Vasc IntervRadiol. 2016; 19(3): 228-236.httos://doi.org/10.1053/.tvir.2016.06.008
Mei Q, He X, Lu W, Li Y. Renal Vein Stenosis after Renal Transplantation: Treatment with Stent Placement. Journal of Vascular and Interventional Radiology. 2010; 21(5): 756-758. https://doi.org/10.1016/1.ivir.2010.01.037
Obed A, Uihlein DC, Zorger N, et al. Severe Renal Vein Stenosis of a Kidney Transplant with Beneficial Clinical Course after Successful Percutaneous Stenting. American Journal of Transplantation. 2008. 8(10): 2173-2176. https://doi.org/10.1111/1.1600- 6143.2008.02356.x
Zhu Y, Tang Y, Peng Y, et al. Identification of Hub Gene and Transcription Factor Related to Chronic Allograft Nephropathy Based on WGCNA Analysis. Kidney Blood Press Res. 2022; 47(10): 631-642. https://doi.org/10.1159/000525386
Levi N, Shavit L, Farkas A, et al. Late Post Native Kidney Biopsy Complication: Renal Pseudoaneurysm Rupture. Isr Med Assoc J. 2022; 24(4): 265-267.
Belavina NI, Manchenko OV, Ivanova ES, Klochkova NN. Rare complication of nephrobiopsy- simultaneous development of pseudoaneurysm and arteriovenous fistula in a renal graft. Nephrology and Dialysis. 2021; 23(4): 524-525 [In Russ]. https://doi.orq/10.28996/2618-9801-2021-4-524-525
Rhee VH, Busch L, Sansone R, et al. Endovascular Occlusion of a Renal Arteriovenous Fistula with Renal Vein Aneursm Formation for Rupture Prevention. Case Rep Vasc Med. 2019; 2019: 8530641. https://doi.org/10.1155/2019/853064113. Nakatani T, Uchida J, Han YS, et al. Renal allograft arteriovenous fistula and large pseudoaneurysm.Clinical Transplantation. 2003;17(1): 9-12. https://doi.org/10.1034/1.1399-0012.2003.02089.x
Zyryanov AV, Borzunov IV, Danilov VO, Makaryan AA. Application of superselective embolization of renal vessels for bleeding in the postoperative period during percutaneous nephrolithotripsy. Urology. 2020; 2: 46-50 fIn Russ]. https://doi.org/10.18565/urology.2020.2.46-50
Semitko SP, Vanyukov AE, Analeev Al, et al. False aneurysm of artery of transplanted kidney: a literature review and an example of successful endovascular treat. ment. Diagnostic & interventional radiology. 2018; 12(1); 65-72 [In Russ].