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

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dc.citation.issue4
dc.citation.volumev. 91
dc.contributor.authorGomes Junior, Manuel Pereira Marques [UNIFESP]
dc.contributor.authorAlves, Claudia Maria Rodrigues [UNIFESP]
dc.contributor.authorBarbosa, Adriano Henrique Pereira [UNIFESP]
dc.contributor.authorCaixeta, Adriano [UNIFESP]
dc.contributor.authorBatista, Marcelo Costa [UNIFESP]
dc.contributor.authorPestana, Jose Osmar Medina [UNIFESP]
dc.contributor.authorCarvalho, Antonio Carlos [UNIFESP]
dc.coverageHoboken
dc.date.accessioned2020-07-20T16:31:22Z
dc.date.available2020-07-20T16:31:22Z
dc.date.issued2018
dc.description.abstractObjectiveTo describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BackgroundThere is no data in the literature about the use of FFR in TRAS. MethodsPatients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe ( 60%) were included. After selective cannulation, a PressureWire 0.014 (CertusSt. Jude Medical) was advanced to the distal portion of the vessel. Resting Pd/Pa ratio (ratio of mean distal to lesion and mean proximal pressures) and translesional systolic pressure gradient were obtained and FFR and hyperemic translesional systolic and mean pressure gradients (HSG and HMG) were registered after papaverine induced maximum hyperemiapre and poststent implantation. Creatinine levels and office blood pressure measurements were registered at the baseline, 6 and 12months after intervention. ResultsTen consecutive patients had successful stent implantation and were included. After treatment, significant increase in FFR (0.760.09 vs. 0.96 +/- 0.04, P<0.001) and reduction in systolic hyperemic gradients (-41.40 +/- 19.18, P<0.001) and mean (-24.00 +/- 11.65, P<0.001) were observed. A strong negative correlation was observed between FFR and percent stenosis diameter%SD (r=-0.89, P<0.001) and HSG (r=-0.9, P<0.001) as well as a strong positive correlation between FFR and baseline Pd/Pa ratio (r=0.9, P<0.001). ConclusionFFR was a well-tolerated, valid and reproducible tool during percutaneous intervention for TRAS. Good correlation was observed between FFR and others hemodynamic parameters of lesion severity.en
dc.description.affiliationUniv Fed Sao Paulo, Div Cardiol, Intervent Cardiol Catheterizat Lab Unit, Escola Paulista Med,UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Dept Nefrol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.affiliationUniv Fed Sao Paulo, Div Cardiol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Cardiol, Intervent Cardiol Catheterizat Lab Unit, Escola Paulista Med,UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Dept Nefrol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Div Cardiol, Escola Paulista Med, UNIFESP,EPM, Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.format.extent820-826
dc.identifierhttp://dx.doi.org/10.1002/ccd.27476
dc.identifier.citationCatheterization And Cardiovascular Interventions. Hoboken, v. 91, n. 4, p. 820-826, 2018.
dc.identifier.doi10.1002/ccd.27476
dc.identifier.issn1522-1946
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/55917
dc.identifier.wosWOS:000427237000026
dc.language.isoeng
dc.publisherWiley
dc.relation.ispartofCatheterization And Cardiovascular Interventions
dc.rightsAcesso aberto
dc.subjectangioplastyen
dc.subjectfractional flow reserveen
dc.subjectkidney transplantationen
dc.subjectrenal artery obstructionen
dc.titleInitial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosisen
dc.typeArtigo
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