Angiotomography in the vascular assessment of recipients before renal transplantation: a profile of excluded patients
Marcelo Lima1, João Oliveira1, Helena Lima2, Marcos Sousa1, Marilda Mazzali1.
1Unicamp, Campinas, Brazil; 2PUC Campinas, Campinas, Brazil
Introduction: Arterial calcification and atherosclerotic lesions, which have a high incidence in chronic renal patients, are important risk factors for immediate and late postoperative complications after renal transplantation. Computed tomography angiography of the iliac arteries can accurately show arterial diseases, including the location and extent of arterial calcification, as well as arterial caliber, which would allow better surgical planning of the site of renal implantation.
Objective: The objective of this study was to stablish the profile of patient that were removed from the waiting list as a result of extensive calcification affecting iliac vessels and to assess the value of CTA diagnostic method for verifying calcification affecting iliac vessels in candidates to renal transplantation.
Methods: It was assessed data of 121 patients in the waiting list who underwent abdominal CTA in prior transplant evaluation between February 2015 and August 2020. Inclusion criteria to be undergone to CTA were patients older than 50 years and that filled some one of the following conditions, like diabetes melitus; hypertension and vascular events.
Results: Sixty-nine (57,02%) patients were classified “not a transplant candidate” (NATC) by absent adequate vascular free area to arterial vessels anastomosis. Fifty-two (42,97%) patients were considered adequated, keeping in the waiting list. There was not statistically significant difference between groups in mean age, dialysis duration mean and comorbidities: diabetes mellitus, hypertension and the both. Previous history of vascular events (isquemic brain stroke, cardiovascular phenomenons or peripheral vascular disease) was most frequent in the NATC group (p<0,05).
Conclusion: Apparently, previous history of cardiovascular events was the factor that better reflected vascular conditions of pelvic region. Computed tomography angiography had a significant value in detecting vascular calcifications, allowing better surgical planning.
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