Acute Renal Artery Stent Thrombosis With a Solitary Functioning Kidney

Torre, J. De La; Hashisho, Mazen M.; Lo, Clement; Mohan, Eugene

doi:10.1016/j.avsg.2010.03.013

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…However, when a renal artery stent occlusion occurs with subsequent renal failure, the diagnosis can be delayed because of nonspecific clinical symptoms and laboratory studies. [5][6][7] As seen in this case, most patients will present with one or more of the following: nonspecific abdominal pain, flank pain, acute hypertension, nausea, vomiting, oliguria, anuria, hematuria, elevated white blood cell count, and elevated serum creatinine concentration. 5,[8][9][10] Although renal ultrasound with Doppler is a valid option for diagnostic purposes, CTA is much more sensitive in detecting renal infarction.…”

Section: Discussionmentioning

confidence: 99%

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Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

Kapoor

Oderich

DeMartino

2019

Journal of Vascular Surgery

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Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Although renal artery restenosis and thrombotic stent occlusion are not rare occurrences, the literature suggests that prompt diagnosis and treatment are essential to preserve renal function, particularly in the setting of occlusion. 5 The patient has provided informed consent and has agreed to publish her case details and images.…”

mentioning

confidence: 99%

Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

Kapoor

Oderich

DeMartino

2019

Journal of Vascular Surgery

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“…In acute kidney failure due to thromboembolic occlusion of a renal artery it is crucial to identify which patients would benefit from renal revascularisation. Multiple variables, including mechanism of occlusion, underlying renal disease, extent and location of thrombus, presence of collateral vessels, and duration of anuria, have been described to predict whether successful restoration of renal function is likely [ 9 , 11 , 13 ]. Anuria time seems to be the best indicator for duration of ischemia and is reversely correlated with recovery of renal function [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Successful Reversal of Acute Kidney Failure by Ultrasound-Accelerated Thrombolysis of an Occluded Renal Artery

Konings

Lely

Nurmohamed

et al. 2014

Case Reports in Medicine

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Purpose. To describe the treatment of renal artery thrombosis with ultrasound-accelerated thrombolysis and discuss the management of prolonged renal ischemia. Case. A 76-year-old patient with a single functional kidney, mild chronic renal impairment, and a recent history of endovascular repair of a thoracoabdominal aneurysm with an aortic branch graft presented with acute flank pain, anuria, and renal failure. The side branch from the aortic stent graft to his single, right, functional kidney appeared to be completely thrombosed. Symptoms had started after cessation of oral anticoagulants because of a planned mastectomy for breast cancer. After identification of the occlusion, ultrasound-accelerated thrombolysis was started 19 hours after the onset of anuria. Angiography, 4 hours after beginning of therapy, already showed partial dissolution of the thrombus and angiographic control after 18 hours showed complete patency of the renal artery side branch. Despite a long period of ischemia, renal function was completely recovered. Conclusion. In patients with acute renal ischemia due to thrombosis of the renal artery, complete recovery of function can be achieved with ultrasound-accelerated thrombolysis, even after prolonged periods of ischemia.

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“…Rapid assessment of patients with acute renal failure is paramount and has been reported in limited cases to provide long-term renal preservation. [2][3][4][5][6][7][8][9][10] The etiology of acute renal dysfunction contributes to the success of saving the kidney from acute insult related to arterial insufficiency. In the largest series in the literature, Ouriel et al described the outcomes of 35 patients treated for acute renal artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

“…Although successful renal revascularization with renal salvage is not common, multiple cases have been reported. [2][3][4][5][6][7][8][9][10] Solitary renal artery thrombosis is rare following surgical revascularization. Suspected acute thrombosis requires urgent evaluation to limit ischemia and maximize possibility of renal preservation.…”

Section: Introductionmentioning

confidence: 99%

Surgical Salvage of Acute Renal Artery Occlusion in the Setting of a Solitary Kidney

Stone

Mossalllati

Schlarb

et al. 2013

Vasc Endovascular Surg

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Management of acute renal artery occlusion in patients with a solitary kidney has a poorly defined prognosis. Loss of renal function is reported by some when acute warm ischemia reaches 2 hours. We report a unique case of a patient that had a 24-hour onset of anuria and acute renal failure upon arrival to the hospital. Nuclear imaging showed trace uptake of the right kidney, without evidence of excretion. Conventional digital subtraction angiography was performed; however, evidence of nephrogram or distal filling of the renal artery was not demonstrated. Secondary to conflicting studies, a computed tomography of the abdomen and pelvis with intravenous contrast revealed only minimal cortical perfusion despite complete occlusion of the previously grafted right renal artery. Patient was taken for urgent hepatorenal bypass surgery. Intraoperative return of urine output occurred immediately after completion of the bypass. Hemodialysis, which was required preoperatively, was stopped after <30 days of bypass procedure. Over 2 years following successful renal salvage, the patient has maintained a normal glomerular filtration rate and patency of her bypass by duplex follow-up.

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Acute Renal Artery Stent Thrombosis With a Solitary Functioning Kidney

Cited by 7 publications

References 18 publications

Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

Successful Reversal of Acute Kidney Failure by Ultrasound-Accelerated Thrombolysis of an Occluded Renal Artery

Surgical Salvage of Acute Renal Artery Occlusion in the Setting of a Solitary Kidney

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