Acute kidney injury following percutaneous mechanical thrombectomy of subclavian artery stent graft thrombosis: a case report

Abstract

Background: Percutaneous mechanical thrombectomy (PMT) is a well-established technique for treatment of acute arterial and venous thrombosis which inevitably leads to intravascular erythrocyte hemolysis, resulting in hemoglobinuria. Case presentation: We present a case of 66-year-old Caucasian female with subclavian artery aneurysm causing distal embolization and hand ischemia. The aneurysm was treated with stent graft, but with a subsequent graft thrombosis 3 months later. After graft recanalisation, AngioJet PMT was performed which resulted in dialysisrequiring acute kidney injury. Conslusion: Only several cases of acute kidney injury following AngioJet PMT have been published in literature. To our knowledge, this is the first reported case of dialysis-requiring AKI after PMT for peripheral arterial thrombosis. Until there is sufficient evidence and recommendation on preventing AKI in this setting, we believe that by being aware of the risk and by monitoring of patient, one might minimize the damage in case it occurs.

Investigating non‐immune haemolytic transfusion reactions in surgical patients

“…Mechanical damage to red cells resulting in intravascular haemolysis was also reported by Mair et al in two patients following percutaneous mechanical thrombectomy (PMI), in which one was reported as AHTR because of the development of haemoglobinuria in the patient 13 . Similar cases of AHTR following PMI have been described 14,15 . There are reports of intravascular haemolysis due to the regurgitant jets following mitral valve repair, causing mechanical damage to the red cells 16,17 .…”

“…13 Similar cases of AHTR following PMI have been described. 14,15 There are reports of intravascular haemolysis due to the regurgitant jets following mitral valve repair, causing mechanical damage to the red cells. 16,17 Recurrent or residual mitral regurgitation presenting as regurgitant-jets are a rare complication of mitral valvuloplasty, which needs re-do surgery in the majority of patients to prevent haemolytic complications.…”