MedPix® Patient Chart - Case No: 4290 :: - Review Images

status post living related donor kidney transplant to the left iliac fossa in February 2001 who had progressive increased creatinine, worsening hypertension and recent renal ultrasound demonstrating high velocities at the anastomosis as well as increased
resistive index in the intrarenal arteries. Patient is not a candidate for magnetic resonance angiography due to the aortic valve replacement and has been on chronic Coumadin. The patient is referred for renal arteriogram and possible angioplasty.

noncontributory

- Review Images for PT: 4290

Contrast angiography with dilute contrast demonstrates a high-grade anastomotic stenosis at the origin of the renal artery extending for approximately 1cm. The renal transplant artery has a relatively acute
upward course from its takeoff from the external iliac artery. There is also eccentric narrowing of the external iliac artery immediately adjacent to the
renal transplant origin.

At angioplasty there is easy dilation of the balloon with an elastic character to the stenosis. Images following angioplasty demonstrate a mildly
improved lumen with residual stenosis of approximately 50%. Pressure measurements after angioplasty demonstrate pressure of 144/80 in the renal
artery and 176/86 in the external iliac artery, giving a gradient of 32mmHg.

- Review Images for PT: 4290

Transplant Renal Artery Stenosis

- Review Images for PT: 4290

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Treatment not available without Diagnosis

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