Intra-arterial computed tomography angiography with ultra-low volume of iodine contrast and stent implantation in transplant renal artery stenosis in terms of contrast-induced kidney injury - a preliminary report.

Autor:	Szczurowska A; Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland., Banasik M; Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland., Kurcz J; Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland., Miś M; Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland., Nowańska K; Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland., Madziarska K; Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland., Mazanowska O; Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland., Krajewska M; Department and Clinic of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland., Garcarek J; Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland., Guziński M; Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland.
Jazyk:	angličtina
Zdroj:	Polish journal of radiology [Pol J Radiol] 2020 Apr 03; Vol. 85, pp. e174-e177. Date of Electronic Publication: 2020 Apr 03 (Print Publication: 2020).
DOI:	10.5114/pjr.2020.94364
Abstrakt:	Purpose: Traditional digital subtraction angiography is still regarded as the gold standard in the diagnostics of transplant renal artery stenosis (TRAS). However, this procedure requires a high volume of iodine contrast medium for optimal visualisation of the renal artery. The aim of this study was to analyse both the usefulness and the safety of intra-arterial computed tomography angiography (IA-CTA) with ultra-low-volume iodine contrast administration in the diagnostic and therapeutic management of TRAS in patients with impaired renal transplant function. Material and Methods: Thirty-three patients with a suspicion of TRAS based on Doppler-ultrasound and clinical setting underwent IA-CTA with ultra-low iodine contrast volume. A special, author-elaborated CTA protocol was used. The volume of 8-18 ml of diluted iodine contrast medium was administered through a catheter with the tip placed 2 cm below the aortic bifurcation. Results: In six patients the CTA examinations revealed TRAS in three configurations: in the anastomosis, in the trunk (critical and high-grade), or in both sections. Stenoses were treated with primary stenting obtaining favourable anatomical outcome. No intervention-related complications were observed. No contrast-induced acute kidney injury was diagnosed in this study. Mean serum creatinine concentration was 2.93 ± 0.89 mg/dl at the baseline and 2.89 ± 1.73 mg/dl and 2.17 ± 0.51 mg/dl after three and seven days from IA-CTA, respectively. Conclusions: Intra-arterial CTA with ultra-low volume of iodine contrast seems to be a safe and reliable diagnostic tool to detect and assess TRAS in the aspect of stent implantation. Application of this imaging modality eliminates the need for a high volume of iodine contrast and thus does not adversely influence renal transplant function. Competing Interests: The authors report no conflict of interest. (Copyright © Polish Medical Society of Radiology 2020.)
Databáze:	MEDLINE
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