Outcome after Major Renovascular Injuries: A Western Trauma Association Multicenter Report

Abstract

Factors associated with a poor outcome following renovascular injuries include blunt trauma, the presence of a grade V injury, and an attempted arterial repair. Patients with blunt major vascular injuries (grade V) are likely to have associated major parenchymal disruption, which contributes to the poor function of the revascularized kidney. These patients may be best served by immediate nephrectomy, provided that there is a functioning contralateral kidney.

Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: pooled cohort analysisPercutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: pooled cohort analysis

“…In support of this, a retrospective analysis from 6 university trauma centers found that elapsed time to operative renal revascularization after major renovascular trauma was not correlated with renal outcome (5). While an occluded renal artery at the time of intervention was significantly associated with treatment failure in our analysis, our case demonstrated successful recanalization and renal preservation despite occlusion of the renal artery.…”

Conservative Management of Major Blunt Renal Trauma with Extravasation: A Viable Option?

“…Often renal exploration for grade IV renal injuries occurs in the setting of other severe associated injuries that require immediate operative exploration, obviating preoperative CT staging and thus requiring intraoperative staging and management [15,16]. In the present series, 57 patients had grade IV renal injuries, 84.2% were managed nonoperatively (36.8% were isolated injuries and 47.4% were associated with nonsignificant abdominal injuries), while the remaining 15.8% of them underwent renal exploration.…”

Renal Injury: 5-Year Experience and Literature Review

“…In these injuries, conservative therapy probably means nephrectomy or observation with possible delayed nephrectomy in the case of unilateral thrombus with a functional contralateral kidney [50] . Some renovascular injuries -blunt, arterial, and grade IV -have a poor outcome [50] and high risk of renovascular hypertension [51] . …”