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Vascular and Interventional Radiology |
1 From the Departments of Radiology (E.N., J.M.L., R.K.K., M.W.W., R.L.G.) and Surgery (R.H., J.S.M.), University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA 94143-0628. From the 1998 RSNA scientific assembly. Received November 20, 1998; revision requested January 11, 1999; final revision received June 18; accepted July 21. Address reprint requests to J.M.L.
PURPOSE: To determine the arteriographic incidence and severity of renal arterial disease in potential renal donors and to evaluate the effect of identifying vascular abnormalities on subsequent donor surgery.
MATERIALS AND METHODS: The records of 716 potential living renal donors who underwent conventional arteriography were reviewed. Abnormal arteriograms were reexamined to characterize vascular disease, and the effect of identifying renovascular disease on subsequent donor surgery was ascertained with chart review.
RESULTS: Renovascular abnormalities were noted in the dictated reports in 78 patients (10.9%). The most common causes were fibromuscular dysplasia and atherosclerosis. The arteriograms of 64 patients were available for retrospective review. Abnormalities were characterized as minimal stenosis (<30% narrowing) in 42 patients and mild stenosis (30%–50% narrowing) in 19 of 61 patients with arteriographic abnormalities at retrospective review. In three patients, no significant abnormality was seen at retrospective review. The effect of detecting renovascular disease on donor selection was determined in 74 of the 78 patients. In 73 of these 74 patients (99%), detection of an abnormality directly affected donor surgery.
CONCLUSION: In this population of potential renal donors, the arteriographic incidence of renovascular disease (10.9%) was higher than previously reported. Although renovascular abnormalities were mild, their detection influenced the plan for donor surgery in almost all patients.
Index terms: Aneurysm, renal, 961.73 • Kidney, transplantation, 961.4551 • Renal angiography, 81.1243, 961.1222 • Renal arteries, fibrodysplasia, 961.7224 • Renal arteries, stenosis or obstruction, 961.721
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