Urgent endovascular maneuvers to rescue a failing transplant kidney with a T-stent approach

Renal artery thrombosis (RAT) is a major cause of renal transplant loss and, for this reason, should be treated promptly. We present a case of a 48-year-old man with external iliac thrombosis associated with thrombosis of a transplant renal artery that led to worsening of renal function. Multiple me...

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Bibliographic Details
Published in:Journal of vascular surgery cases and innovative techniques 2023-06, Vol.9 (2), p.101168, Article 101168
Main Authors: Cavenaghi, Astrid Sofia, Cappiello, Antonio, Pini, Rodolfo, Faggioli, Gianluca, La Manna, Gaetano, Gargiulo, Mauro
Format: Article
Language:English
Subjects:
Case report
Drug-eluting stent
Endovascular recanalization
Iliac artery stenting
Iliac artery thrombosis
Kidney injury
Renal artery stenting
Renal artery thrombosis
Renal transplantation
Thromboaspiration
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Summary:Renal artery thrombosis (RAT) is a major cause of renal transplant loss and, for this reason, should be treated promptly. We present a case of a 48-year-old man with external iliac thrombosis associated with thrombosis of a transplant renal artery that led to worsening of renal function. Multiple mechanisms have been identified in the literature as risk factors for RAT. In our patient, a combination of anastomotic stenosis, hypercoagulability, and diabetic nephropathy had resulted in RAT, and an unconventional endovascular revascularization technique with a T-stent approach was needed to guarantee patency of the treated vessels. No 30-day perioperative complications occurred, and the postoperative follow-up examination showed patency of the treated vessels; thus, transplant loss was avoided.
ISSN:2468-4287
2468-4287
DOI:10.1016/j.jvscit.2023.101168