Arellano Soto Jorge, Ortega Santamaria Enrique Amador, Vergara Martínez Felix Adrian, Espinoza Pérez Ramón, Avelar Garnica Francisco J, Morinelli Astorquizaga María Alejandra, Flores Juárez Adriana Irais, Hernández Ballesteros Samuel, Figueroa García Juan, Hernández Rivera Juan Carlos H
Diagnostic and Therapeutic Imaging Department, Hospital de Especialidades Centro Medico Nacional (CMN) Siglo XXI, Mexico City, MEX.
Kidney Transplant Unit, Hospital de Especialidades Centro Medico Nacional (CMN) Siglo XXI, Mexico City, MEX.
Cureus. 2025 Aug 2;17(8):e89265. doi: 10.7759/cureus.89265. eCollection 2025 Aug.
Introduction Kidney transplant (KT) offers the best renal replacement therapy (RRT), not without being exempt from medical-surgical complications, highlighting those that impact graft function with elevated serum creatinine compounds, such as transplant renal artery stenosis (TRAS), and this study, in turn, has presented some gaps in knowledge, such as anti-aggregation therapy, essentially after the interventionist handling activity. The objective of this document is to propose a platelet anti-aggregation scheme and show the behavior of a series of cases, with a review of the literature. Materials and methods This is a case report of patients with TRAS for five years and six months; patients with a clinical imaging diagnosis of TRAS were included, who were managed with intervention and follow-up. Results In the study, a prevalence of 1.35% (11 of 813) of confirmed cases treated with angioplasty was documented; of the 11 cases, one had restenosis, and another had a thrombotic event requiring reintervention. Antiplatelet therapy was used in 11 patients: one patient was diagnosed at examination, three on the day of angioplasty, and seven cases within seven days after angioplasty. The duration of maintenance with dual or single antiplatelet therapy has not been standardized; in our cases, dual therapy lasted 1-9 months, followed by single antiplatelet therapy. Conclusions The interventional treatment of TRAS is safe; however, there is variability, and antiplatelet therapy is not standardized. This antiplatelet therapy should be determined based on risk factors, stenosis characteristics, and comorbidities. Based on all of this, this study is proposed to standardize antiplatelet therapy.
引言 肾移植(KT)是最佳的肾脏替代疗法,但并非没有外科手术并发症,尤其是那些会影响移植肾功能并导致血清肌酐化合物升高的并发症,例如移植肾动脉狭窄(TRAS)。而本研究在知识方面存在一些空白,例如抗聚集治疗,尤其是在介入治疗后。本文的目的是提出一种血小板抗聚集方案,并通过文献综述展示一系列病例的情况。
材料与方法 这是一份关于TRAS患者长达五年零六个月的病例报告;纳入临床影像学诊断为TRAS且接受了干预和随访的患者。
结果 在该研究中,记录到血管成形术治疗的确诊病例患病率为1.35%(813例中的11例);在这11例病例中,1例出现再狭窄,另1例发生血栓事件需要再次干预。11例患者使用了抗血小板治疗:1例在检查时被诊断,3例在血管成形术当天诊断,7例在血管成形术后7天内诊断。双联或单联抗血小板治疗的维持时间尚未标准化;在我们的病例中,双联治疗持续1至9个月,随后是单联抗血小板治疗。
结论 TRAS的介入治疗是安全的;然而,存在变异性,且抗血小板治疗未标准化。这种抗血小板治疗应根据危险因素、狭窄特征和合并症来确定。基于以上所有情况,本研究旨在使抗血小板治疗标准化。