Endovascular therapy of iliac artery stenosis proximal to the anastomosis in kidney transplantation: A case report

Impairment of kidney graft perfusion, arterial hypertension and lower limb ischemia may result from iliac artery stenosis proximal to the anastomosis of a renal transplant. This case report describes a renal transplant patient who developed claudication of the limb ipsilateral to the iliac artery where the transplant was performed. Echo-color-Doppler ultrasound revealed iliac artery stenosis proximal to the anastomosis, which was subsequently confirmed by digital subtraction angiography (DSA). The stenosis was successfully treated with percutaneous transluminal angioplasty (PTA) and stenting. Routine follow-up examinations showed good anatomic result, improved renal hypertension and resolution of claudication. These observations confirm that renal transplant patients are at risk of developing atherosclerosis of the iliac artery proximal to anastomosis. Echo-color-Doppler ultrasound is a less invasive method for diagnosis and follow-up monitoring. PTA plus stenting is a viable treatment option that can resolve renal perfusion and lower limb claudication.