Renal Transplant Artery Inflow Stenosis Treated with Femorofemoral Bypass.

Autor:	Ortiz CC; Department of Surgery, Northwell Health, Manhasset, New York., Miyara SJ; Department of Surgery, Northwell Health, Manhasset, New York.; Department of Emergency Medicine, Northwell Health, Manhasset, New York.; Elmezzi Graduate School of Molecular Medicine, Manhasset, New York., Cagliani JA; Department of Surgery, Northwell Health, Manhasset, New York., Cho YM; Department of Surgery, Northwell Health, Manhasset, New York., Guevara S; Department of Surgery, Northwell Health, Manhasset, New York., Hayashida K; Department of Emergency Medicine, Northwell Health, Manhasset, New York., Shinozaki K; Department of Emergency Medicine, Northwell Health, Manhasset, New York., Clement D; Department of Surgery, Northwell Health, Manhasset, New York., Becker LB; Department of Emergency Medicine, Northwell Health, Manhasset, New York.; Elmezzi Graduate School of Molecular Medicine, Manhasset, New York., Wang B; Department of Surgery, Northwell Health, Manhasset, New York., Krishnasastry KV; Department of Surgery, Northwell Health, Manhasset, New York., Teperman LW; Department of Surgery, Northwell Health, Manhasset, New York., Molmenti EP; Department of Surgery, Northwell Health, Manhasset, New York.
Jazyk:	angličtina
Zdroj:	The International journal of angiology : official publication of the International College of Angiology, Inc [Int J Angiol] 2020 May 16; Vol. 30 (4), pp. 310-312. Date of Electronic Publication: 2020 May 16 (Print Publication: 2021).
DOI:	10.1055/s-0040-1709502
Abstrakt:	In this case report we describe a novel and successful revascularization approach in instances of allograft and distal limb ischemia after kidney transplantation. Stenosis proximal to transplant renal artery anastomoses is a complication leading to allograft dysfunction and/or loss. We present a femorofemoral bypass graft with ringed polytetrafluoroethylene (PTFE). In this occasion, revascularization was achieved by a backflow mechanism. The approach described achieved its goal of revascularizing the allograft as well as the distal extremity, with both short- and long-term successful outcomes. Benefits of this approach when compared with re-implantation or procedures directly involving the transplant renal artery include minimization of ischemic time, no need to repair the stenosis, anastomoses with vessels of greater diameter, no need to perfuse the kidney, no need to take down the renal artery anastomosis, no need to dissect the transplanted kidney, and no further lower extremity ischemia. This approach does not require any proximal temporary inflow occlusion (as seen with stent placement) or clamping of the arterial inflow to the kidney. This procedure was completed without having to infuse any preservation fluid into the kidney. Competing Interests: Conflict of Interest None. (International College of Angiology. This article is published by Thieme.)
Databáze:	MEDLINE
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