3D rotational angiography of transplanted kidneys

Abstract

Purpose: To develop a protocol for 3D rotational angiography (3D-RA) of the transplant renal artery.

Material and Methods: 3D-RA was consecutively performed in 39 renal transplanted patients with suspicion of renal artery stenosis. A series of images were acquired while the C-arm of the equipment rotated around the region of interest. Contrast media in different concentrations were given through a 1.4 mm catheter with different sites of injection in the ipsilateral iliac artery. The 3D reconstructions were done at a workstation. Suspected stenoses were in most cases verified with pressure measurement, and a systolic pressure gradient of 10 mm Hg or more was regarded as significant.

Results: 28 stenoses were found in 24/39 patients (62%); 21/28 (75%) were verified by pressure measurement. The 3D reconstructions gave a better description of the stenoses in 10 patients.

Conclusion: 3D-RA is a helpful supplement in cases with complicated vascular anatomy, especially when intervention may be indicated. The best results were achieved with the catheter tip in the proximal iliac artery and 70–75 ml of a high concentration contrast medium at a flow rate of 8–10 ml/s.