scholarly journals Successful endovascular treatment for acute renal artery occlusion

2021 ◽  
Author(s):  
Hai-Lei Li ◽  
Yiu Che CHAN ◽  
Zongjin GUO ◽  
Ruming ZHOU ◽  
Stephen W CHENG
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Sudden Onset ◽  
Left Renal Artery ◽  
Thrombus Aspiration ◽  
Total Occlusion ◽  
Aspiration Thrombectomy ◽  
Catheter Directed Thrombolysis ◽  
Local Fibrinolysis

Abstract Purpose: We report a case of revascularization for a totally occluded renal artery using endovascular renal thrombus aspiration followed by catheter-directed thrombolysis.Case Report: A 56 years old man presented with sudden onset of severe left-sided abdominal and loin pain for six hours. Urgent computed tomography angiogram showed total occlusion of left renal artery. Emergency selective left renal angiogram and thrombus aspiration using a 5-French Cobra catheter was performed. Catheter-directed thrombolysis with urokinase was initiated after aspiration thrombectomy. Angiogram 24 hours after thrombolysis showed the left renal artery and its segmental branches were successfully revascularized. Patient was on anticoagulation after operation and his renal function recovered well.Conclusion: Percutaneous aspiration thrombectomy combined with intra-arterial local fibrinolysis are effective in the salvage of renal function.

Renal Function Salvage After Delayed Endovascular Revascularization of Acute Renal Artery Occlusion in Patients With Fenestrated-Branched Endovascular Aneurysm Repair or Visceral Debranching

2018 ◽  
Vol 25 (4) ◽  
pp. 466-473 ◽  
Author(s):  
Franziska Heidemann ◽  
Tilo Kölbel ◽  
E. Sebastian Debus ◽  
Holger Diener ◽  
Sebastian W. Carpenter ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Stent Graft ◽  
Aortic Surgery ◽  
Artery Occlusion ◽  
Aspiration Thrombectomy ◽  
Endovascular Revascularization ◽  
Renal Artery Occlusion ◽  
Local Lysis

Purpose: To analyze the renal function and outcome after delayed (>6 hours) endovascular revascularization of acute renal artery occlusion (RAO) in patients with fenestrated-branched endovascular aneurysm repairs (EVARs) or open visceral debranching. Methods: A single-center retrospective analysis was conducted involving 7 patients (mean age 61 years, range 49–72; 5 women) with 9 RAOs treated with endovascular revascularization between December 2014 and March 2017. Three patients had a solitary kidney with chronic renal insufficiency; 1 patient had bilateral occlusions as the acute event. Initial aortic surgery included 5 branched and 1 fenestrated EVAR as well as 1 open visceral debranching operation. Revascularization of the RAO was performed using aspiration thrombectomy, local lysis therapy, and stent-graft relining. The median time between initial aortic surgery and RAO was 10 months (range 0.5–17). Results: Median renal ischemic time to revascularization was 24 hours (range 7–168). Technical success was 100%, with 1 procedure-related access complication. Temporary dialysis dependency occurred in 4 patients. Mean in-hospital stay was 17 days (range 7–32) with 1 postoperative death at day 10 due to cardiac arrest of unknown cause. Mean follow-up was 10.3 months (range 1.5–27) in 5 of 6 discharged patients. During follow-up, 1 reintervention for recurrent occlusion was performed. At follow-up imaging, all renal arteries were patent. No permanent dialysis dependency occurred. Conclusion: Renal function can be salvaged by delayed revascularization for RAO with prolonged renal ischemia. The endovascular approach with aspiration thrombectomy, local lysis, and stent-graft relining is a feasible technique for revascularization after RAO in patients with fenestrated-branched EVAR or open visceral debranching.

scholarly journals Renal salvage using stent graft placement after acute renal artery occlusion with prolonged ischemic time

2020 ◽  
Vol 9 ◽  
pp. 204800402094052
Author(s):  
Yue Gao ◽  
Dimitrios Miserlis ◽  
G Matthew Longo ◽  
Nitin Garg
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Renovascular Hypertension ◽  
Stent Graft ◽  
Artery Occlusion ◽  
Renal Arteries ◽  
Left Renal Artery ◽  
Ischemic Time ◽  
Graft Placement ◽  
Renal Artery Occlusion

Purpose To describe a patient with acute renal artery occlusion who underwent successful revascularization procedure after experiencing a protracted ischemic period, which resulted in successful retrieval of renal function. Case report A 58-year-old male with a history of left renal artery stenosis and stent graft placement presented with symptoms of chest pain, shortness of breath, and flank pain. The patient was admitted to the Intensive Care Unit with the diagnosis of multiorgan failure and subsequent anuria that led to the initiation of hemodialysis. Computed tomography angiography demonstrated an aortic occlusion along with bilateral proximal renal artery occlusion with reconstitution of the mid to distal renal arteries via collateralization. The patient underwent angioplasty with bilateral renal artery stent-graft placement and successful revascularization of proximal renal arteries. Post-operatively, his renal function and urine output improved, and the patient was able to be weaned off hemodialysis along with the benefit of concurrent amelioration of his renovascular hypertension. Conclusion For select patients with renal artery occlusion, revascularization of the renal arteries may result in dialysis independence and stabilization of renovascular hypertension, despite prolonged time of ischemia.

Recovery of Renal Function after Renovascular Surgery

1981 ◽  
Vol 26 (1) ◽  
pp. 27-31 ◽  
Author(s):  
A. Mackay
Keyword(s):  
Blood Pressure ◽  
Renal Function ◽  
Renal Artery ◽  
Renal Artery Stenosis ◽  
Reconstructive Surgery ◽  
Severe Hypertension ◽  
Artery Occlusion ◽  
Unilateral Nephrectomy ◽  
Left Renal Artery ◽  
Renal Artery Occlusion

A 48-year-old woman with generalised atheromatous disease had a right nephrectomy for a renal artery occlusion in 1977. Fourteen months later she presented with severe hypertension and anuria, caused by occlusion of the left renal artery. Emergency reconstructive surgery was successful in bringing about recovery of renal function and lowering of her blood pressure. Because renal function had deteriorated slightly after the first operation and improved after the second, a comparison was made of the effects of unilateral nephrectomy and reconstructive surgery on renal function in a further 26 patients with renal artery stenosis. In 15 patients having nephrectomy, renal function deteriorated in most, while in 11 having reconstruction it improved in nine and remained constant in two.

Traumatic Renal Artery Occlusion in a Patient with a Solitary Kidney: Case Report of Treatment with Endovascular Stent and Review of the Literature

2007 ◽  
Vol 73 (4) ◽  
pp. 351-353 ◽  
Author(s):  
Jason M. Dowling ◽  
Matthew W. Lube ◽  
Chadwick P. Smith ◽  
Joseph Andriole
Keyword(s):  
Case Report ◽  
Renal Artery ◽  
Left Kidney ◽  
Solitary Kidney ◽  
Artery Occlusion ◽  
Left Renal Artery ◽  
Endovascular Stent ◽  
Total Occlusion ◽  
Renal Artery Occlusion

Renal artery occlusion after blunt trauma is a rare occurrence, and the optimal treatment for this condition has not been established. To our knowledge, endovascular repair for blunt renal artery occlusion in a solitary kidney has not been described in the literature. This case report describes a 42-year-old woman with a solitary left kidney presenting with total occlusion of the left renal artery after a significant crush injury. She was successfully treated by percutaneous placement of an endovascular stent. Postprocedure, the patient developed acute renal failure requiring temporary dialysis. At follow-up 4 months later, the patient has normal urinary output and a normal creatinine.

scholarly journals Restoration of renal function by a novel prostaglandin EP4 receptor-derived peptide in models of acute renal failure

2013 ◽  
Vol 304 (1) ◽  
pp. R10-R22 ◽  
Author(s):  
Martin Leduc ◽  
Xin Hou ◽  
David Hamel ◽  
Melanie Sanchez ◽  
Christiane Quiniou ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Hek293 Cells ◽  
Heme Oxygenase 1 ◽  
Histological Changes ◽  
Ep4 Receptor ◽  
Renal Artery Occlusion

Acute renal failure (ARF) is a serious medical complication characterized by an abrupt and sustained decline in renal function. Despite significant advances in supportive care, there is currently no effective treatment to restore renal function. PGE2 is a lipid hormone mediator abundantly produced in the kidney, where it acts locally to regulate renal function; several studies suggest that modulating EP4 receptor activity could improve renal function following kidney injury. An optimized peptidomimetic ligand of EP4 receptor, THG213.29, was tested for its efficacy to improve renal function (glomerular filtration rate, renal plasma flow, and urine output) and histological changes in a model of ARF induced by either cisplatin or renal artery occlusion in Sprague-Dawley rats. THG213.29 modulated PGE2-binding dissociation kinetics, indicative of an allosteric binding mode. Consistently, THG213.29 antagonized EP4-mediated relaxation of piglet saphenous vein rings, partially inhibited EP4-mediated cAMP production, but did not affect Gαi activation or β-arrestin recruitment. In vivo, THG213.29 significantly improved renal function and histological changes in cisplatin- and renal artery occlusion-induced ARF models. THG213.29 increased mRNA expression of heme-oxygenase 1, Bcl2, and FGF-2 in renal cortex; correspondingly, in EP4-transfected HEK293 cells, THG213.29 augmented FGF-2 and abrogated EP4-dependent overexpression of inflammatory IL-6 and of apoptotic death domain-associated protein and BCL2-associated agonist of cell death. Our results demonstrate that THG213.29 represents a novel class of diuretic agent with noncompetitive allosteric modulator effects on EP4 receptor, resulting in improved renal function and integrity following acute renal failure.

The Application of R.E.N.A.L. Nephrometry Score In Laparoscopic Partial Nephrectomy With Zero Ischemia And Sutureless

2021 ◽  
Author(s):  
Yi Mu ◽  
Kehang Chen ◽  
Jun He ◽  
Peng Chen ◽  
Miao Liu ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Renal Function ◽  
Renal Artery ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Artery Occlusion ◽  
Nephrometry Score ◽  
Renal Artery Occlusion ◽  
Zero Ischemia

Abstract Background: To evaluate the application of R.E.N.A.L. nephrometry score (RNS) in laparoscopic partial nephrectomy (LPN) with zero ischemia and sutureless surgery, and to explore the efficacy and safety of zero ischemia and seamless LPN in the treatment of renal cell carcinoma.Methods: The clinical data of 67 patients with renal cell carcinoma treated by LPN in the affiliated Hospital of Guizhou Medical University from January 2016 to July 2020 were analyzed retrospectively. The patients were divided into renal artery occlusion group (n=31) and non-occlusion group (n=36). All cases were divided according to their RNS (low, moderate, and high), and the perioperative condition, postoperative complications, postoperative recovery and changes of renal function in the two groups were analyzed.Results: According to the RNS, all cases were classified in low-complex. Both groups successfully completed the operation without operative complications. Compared with the renal artery occlusion group, the non-occlusion group had a shorter operation time (35.51±20.48 min), shorter hospital stay (6.72±4.39 d), and no significant difference in intraoperative blood loss(50.39±30.19 ml). During the 6-month follow-up, the creatinine value of the renal function in the non-occlusion group (78.47±10.98μmol/L) was lower than that in the occlusion group(98.21±8.06μmol/L).Conclusion: Zero-ischemia sutureless LPN technique can effectively reduce the time of ischemia and avoid renal ischemia-reperfusion injury. This surgical technique may be a feasible surgical method for the treatment of low RNS renal cell carcinoma.

Successful Repair of Acute Type B and Retrograde Type A Aortic Dissection With Kidney Ischemia

2017 ◽  
Vol 51 (5) ◽  
pp. 342-345 ◽  
Author(s):  
Jeko M. Madjarov ◽  
Michael G. Katz ◽  
Hector Crespo-Soto ◽  
Svetozar Madzharov ◽  
Timothy Roush ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Aortic Dissection ◽  
Renal Artery ◽  
Kidney Injury ◽  
Renal Ischemia ◽  
Left Renal Artery ◽  
Acute Type ◽  
Type B ◽  
Type A Aortic Dissection

Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia. Evaluation of renal function was performed by the means of internationally accepted Risk, Injury, Failure, Loss of kidney function, End stage kidney disease and Acute Kidney Injury Network classifications for acute kidney injury, renal duplex sonography, and intravascular ultrasound that demonstrated left renal artery dissection with a flap completely compressing the true lumen. The patient underwent thoracic endovascular aortic repair and left renal artery stent and recovered well. Six months later, at the follow-up visit, retrograde type A aortic dissection was found, which was successfully repaired. Reversal of renal ischemia after aortic dissection depends on the precise assessment of renal function and prompt intervention.

Patterns of Renal Function in Hypertension Due to Unilateral Renal Artery Occlusion

1992 ◽  
Vol 14 (6) ◽  
pp. 1067-1081 ◽  
Author(s):  
Yuji Tsuji ◽  
David A. Goldfarb ◽  
Zenjiro Masaki ◽  
Carlos M. Ferrario
Keyword(s):  
Renal Function ◽  
Renal Artery ◽  
Artery Occlusion ◽  
Renal Artery Occlusion
Sign in / Sign up

Export Citation Format

Share Document