Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis

Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of... INTRODUCTIONTransplant renal artery stenosis (TRAS) is the main vascular complication of renal transplant, responsible for at least 75% of the cases. Although often asymptomatic and underdiagnosed, it is responsible for 1–5% of the resistant hypertension cases and the leading cause of graft dysfunction and premature death of the receiver .TRAS has widely varying prevalence in the literature, from 1 to 23% , due to different factors: the expansion in the use of noninvasive diagnostic methods as a screening tool, the differences in anastomosis techniques and graft preservation and also the absence of clear standardization of diagnostic criteria, especially regarding the definition of hemodynamically significant disease.Angiography remains as gold standard for TRAS diagnosis. However, the precise correlation between the hemodynamic repercussion and the severity of stenosis measured remains under evaluation, with a great heterogeneity in the values used as threshold for surgical or percutaneous revascularization .Fractional flow reserve (FFR) is the method of choice for the evaluation of the hemodynamic repercussion of epicardial stenosis in patients with coronary artery disease. Its use in candidate selection for myocardial revascularization is associated with a significant reduction in the incidence of cardiovascular events and costs . More recent studies have indicated that the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Catheterization and Cardiovascular Interventions Wiley

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1522-1946
eISSN
1522-726X
D.O.I.
10.1002/ccd.27476
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONTransplant renal artery stenosis (TRAS) is the main vascular complication of renal transplant, responsible for at least 75% of the cases. Although often asymptomatic and underdiagnosed, it is responsible for 1–5% of the resistant hypertension cases and the leading cause of graft dysfunction and premature death of the receiver .TRAS has widely varying prevalence in the literature, from 1 to 23% , due to different factors: the expansion in the use of noninvasive diagnostic methods as a screening tool, the differences in anastomosis techniques and graft preservation and also the absence of clear standardization of diagnostic criteria, especially regarding the definition of hemodynamically significant disease.Angiography remains as gold standard for TRAS diagnosis. However, the precise correlation between the hemodynamic repercussion and the severity of stenosis measured remains under evaluation, with a great heterogeneity in the values used as threshold for surgical or percutaneous revascularization .Fractional flow reserve (FFR) is the method of choice for the evaluation of the hemodynamic repercussion of epicardial stenosis in patients with coronary artery disease. Its use in candidate selection for myocardial revascularization is associated with a significant reduction in the incidence of cardiovascular events and costs . More recent studies have indicated that the

Journal

Catheterization and Cardiovascular InterventionsWiley

Published: Jan 1, 2018

Keywords: ; ; ;

References

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