Pdf acute transplant renal artery thrombosis due to. It may present with either chronic bilateral thrombosis or, less often, with acute unilateral or bilateral thrombosis. Pdf renal artery thrombosis caused by stent fracture. In a series of over 14,000 autopsies, about 200 cases of kidney infarction were identified a prevalence of 14. A 63yearold male patient with renalartery thrombosis presented 48 hours after the onset of acute nonradiating flank pain. In carefully selected patients, renal angioplasty improves blood pressure and kidney function with minimal risk. Renal artery occlusion wright 2001 bju international. In acute situations, thrombolytic clotbusting medication may be infused into the renal artery for several hours to several days to break up the clot. Ask the experts etiology of renal artery thrombosis in renal. Renal artery infarction is a rare condition with a reported incidence of 0. The renal vein is more commonly affected than the renal artery. Renal vein thrombosis genitourinary disorders merck. Successful percutaneous renal intervention in a patient with. This case report aims to report the outcomes of the endovascular management of the acute and simultaneous thrombosis of both renal covered stent grafts after bilateral renal arteries chimney technique for endovascular repair chevar of a juxtarenal abdominal aortic aneurysm.
Angiography, blunt abdominal trauma, percutaneous endovascular revascularization, renal artery thrombosis introduction isolated renal artery thrombosis rat following blunt trauma is very rare 1. Emergency physicians and other physicians need to consider this diagnosis in unexplained flank pain, especially in patients with risk factors for this disease. The largest case series of emergency department patients give a prevalence of 0. Feb, 2018 renal artery stenosis may cause no signs or symptoms until the condition reaches an advanced state. It is a more difficult problem, however, to suspect this condition on the basis of simpler roentgenographic procedures and to refer suitable candidates for definitive angiographic study. Apr 20, 2011 renal vein thrombosis is the occlusion of one or both renal veins.
Renal artery thrombosis or embolus is a rare condition that may lead to hypertension and renal failure. When reported, it has usually occurred superimposed on an underlying anatomic abnormality of the renal artery after trauma, or very rarely in the setting of systemic. Stenosis and occlusion are usually due to thromboemboli, atherosclerosis, or fibromuscular dysplasia. A 66yearold female presented with abdominal pain and acute kidney injury aki. What are the potential etiologies of renal artery thrombosis after renal transplantation when there is no evidence of rejection on the renal biopsy miguel angel ortiz mtz. There has been a relative increase in its diagnosis with the help of advanced imaging techniques, such as computed tomography ct 2. Renal artery thrombosis renal artery thrombosis is the formation of a clot in a renal artery. Aortic thrombosis fibrinolysis neonatal hypertension renal artery thrombosis renal ischemia urokinase introduction aortic thrombosis is a welldescribed complication of ind welling aortic catheters in the critically ill neonate. The cause for renal artery thrombosis in renal allograft patients is multifactorial. Thrombosis formation of a blood clot in an artery or vein of a living person arterial thrombosis denies oxygen and nutrition to an area of the body thrombosis of an artery leading to the heart causes a myocardial infarction thrombosis of an artery leading to the brain causes a stroke. Case report endovascular revascularization for isolated renal. However, thrombus formation may be delayed until after the first week 3. Surgical and technical errors are the major cause of renal artery thrombosis. Aspirin is sometimes used to prevent renal vein thrombosis in people who have had a kidney transplant.
It may be associated with other thromboembolism, including pulmonary embolism. Percutaneous rheolytic thrombectomy for treatment of acute. Pdf acute transplant renal artery thrombosis due to distal. Renal artery thrombosis is the most common complication of renal vascular reconstruction and is most common after either placement of a dacron graft or endarterectomy. Acute renal artery thrombosis treated by percutaneous. As it expands, it compresses the plaque against the artery walls, reopening the vessel for blood to flow through. Once the artery is open, the physician may insert a stent at the site to keep the artery open and support the arterial wall. Although ocps have been strongly associated with venous thrombosis, we report left accessory renal artery thrombosis leading to acute. Renal artery stenosis is a decrease in blood flow through one or both of the main renal arteries or their branches. Either thromboemboli or in situ thrombi may cause complete occlusion of the main renal artery or smaller segmental branch arteries 1,7. Oct 23, 2017 renal vein thrombosis rvt is a blood clot that forms in the renal vein. Jul 15, 2015 neonatal renal vascular thrombosis is rare but has devastating sequelae. If spontaneous renal artery thrombosis is not diagnosed early and is not treated properly, it results in renal insufficiency due to renal infarction. Evolving treatments for arterial and venous thrombosis.
Renal artery thrombosis definition of renal artery. Renal artery disease management and treatment cleveland. Blood thinners such as warfarin may be recommended for some people with chronic kidney disease. A case of renal artery thrombosis with renal infarction. Diagnosis and management of renalartery thrombosis report. Traumatic renal artery occlusion usually occurs in the left side and mostly seen before the age figure 1. In most cases, there is no specific way to prevent renal vein thrombosis. Thromboemboli usually originate from a thrombus in the heart or aorta, and in situ thrombosis is usually due to an underlying hypercoagulable condition or injury to or dissection of a renal artery. We present a case of acute renal artery thrombosis due to disseminated zygomycosis in a healthy young adult male. New thrombolytic infusion application of dissolving renal.
Clot propagation to the renal arteries may result in renal. There are numerous etiologies for bland thrombus, but it most commonly occurs in the hypercoagulable nephrotic syndrome. Keeping enough fluids in the body may help reduce risk. Since then, numerous addi tional reports concerning renal vein thrombosis in infants and. Most neonates with renal vein thrombosis present with at least one of the three cardinal signs, namely, abdominal mass, macroscopic hematuria and thrombocytopenia, while unilateral renal artery thrombosis presents with transient hypertension. A thrombosis of a renal artery may cause kidney failure because of blocked blood flow to the kidney. Renal artery thrombosis as a complication of umbilical arterial catheterisation is a common cause of neonatal hypertension. Well tell you about these clots, how to diagnose them, and treatment options. Thrombosis of the renal artery is not a frequent condition, but it is not nearly so rare as is indicated by the number of times it is diagnosed. Aug 31, 2018 the chimneyperiscope technique has been used to address complex aortic pathologies. Treatment options in the past have had limited success.
The incidence of renal injures increases in preexisting congenital or acquired renal pathology. Practically all the cases reported are those found a. Apr 20, 2002 the cause for renal artery thrombosis in renal allograft patients is multifactorial. Intrathrombic urokinase reverses neonatal renal artery. Followup renal angiogram at 1 week c and 2 weeks d showed significantly improved renal perfusion. Successful percutaneous renal intervention in a patient. Golbus and colleagues report a case of renal artery thrombosis secondary to oral contraceptives 1. Renal artery thrombosis an overview sciencedirect topics. The patient was released from the hospital with a patent renal unit and ameliorated serum creatinine concentration. Renal artery thrombosis in a young woman taking oral. Case report oral contraceptive causing renal artery.
Thrombosis may initially involve the renal artery or more frequently the renal vein, but in some cases it is difficult to ascertain where the thrombosis. Renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. Although both conditions ultimately cause renal ischemia, the etiologies, presentation, treatment strategies, and ultimate prognoses of occlusion of the renal artery and vein are quite different. Diagnosis and management of renalartery thrombosis. Few cases of thrombosis of the renal artery have been reported in the literature. Acute posttraumatic bilateral renal artery thrombosis is a rare phenomenon and has been sparsely described in the literature. Renal artery occlusion is a complete blockage of blood flow through one or both of the main renal arteries or its branches. Renal artery thrombosis thrombosis of renal artery. What are the potential etiologies of renal artery thrombosis after renal transplantation when there is no evidence of rejection on the.
Your doctor may also suspect a problem if you have. The chimneyperiscope technique has been used to address complex aortic pathologies. An unusual cause of acute abdomen shantanu singh, li wang, qi sheng yao, juthika jyotimallika, shivank singh department of urology and andrology, taihe hospital affiliated to hubei university of medicine, shiyan, hubei. Thrombosis was documented by ct angiography, 99m tcdtpa, and digital subtraction. Full textfull text is available as a scanned copy of the original print version. The diagnosis of renal artery occlusion was made on contrastenhanced ct cect and confirmation of etiology was made only on post mortem ncbi. We present a case which demonstrates the use of percutaneous rheolytic therapy with the angiojet atherectomy catheter to treat this condition in the acute setting. The diagnosis of acute rao is challenging as the disease is rare and the.
Although renal vein thrombosis rvt has numerous etiologies, it occurs most commonly in patients with nephrotic syndrome ie, 3 gday protein loss in the urine, hypoalbuminemia, hypercholesterolemia, edema. Doacs are cleared through renal and extrarenal pathways. Ct whole body multiphase protocol with bolus tracking allows assessment of renal artery thrombosis during the arterial phase as enhancement defect of renal artery and absence of nephorographic effect during the neproghraphic phase at 70s. Acute renal artery thrombosis after kidney transplantation. Oct 31, 2018 although renal vein thrombosis rvt has numerous etiologies, it occurs most commonly in patients with nephrotic syndrome ie, 3 gday protein loss in the urine, hypoalbuminemia, hypercholesterolemia, edema. Renal artery thrombosis and ischaemia presenting as severe. Predisposing factors include small dacron grafts, renal atrophy associated with thinwalled diseased arteries and high intrarenal vascular resistance, hypotension, and hypovolemia. Links to pubmed are also available for selected references. Acute renal artery occlusion rao is an uncommon disease that carries the signi. With mdct, we made the diagnosis within hours of presentation even though ultrasound findings were normal. Acute renal arterial thrombosis, renal artery occlusion nephrology abrupt occlusion of ra which, if complete, may cause permanent renal failure.
Get a printable copy pdf file of the complete article 2. The clinical manifestations of renal artery thrombosis are as yet not well recognized and therefore not thought of. Renal artery thrombosis is a rare, but serious and often underdiagnosed condition. If spontaneous renal artery thrombosis is not diagnosed early and is not treated properly, it results in. Apr 22, 2002 renal artery thrombosis or embolus is a rare condition that may lead to hypertension and renal failure. Renal vein thrombosis rvt is the formation of a clot in the vein that drains blood from the kidneys, ultimately leading to a reduction in the drainage of one or both kidneys and the possible migration of the clot to other parts of the body. Most people with renal artery stenosis have no signs and symptoms. Renal vein thrombosis is thrombotic occlusion of one or both main renal veins, resulting in acute kidney injury or chronic kidney disease. Mechanisms of thrombosis maureane hoffman, md, phd professor of pathology.
Renal artery thrombosis is a rare complication with an incidence of 1%, usually the consequence of technical problems during surgery. We report a case of bilateral renal artery thrombosis secondary to acute necrotizing pancreatitis. Most cases of renal allograft thrombosis occur early in the postoperative period with a peak incidence of 48 h. Case report endovascular revascularization for isolated.
Spontaneous thrombosis of the renal artery is a rare event. Depending on the rare occurrence of renal artery thromboembolism due to its rareness and its being less known, a correct diagnosis and a correct treatment are often delayed. Blood clotting where it shouldnt or when you dont want it to. It is not my intention to question the relation between such medication and the development of thrombosis, but i wish to comment on. Possible causes for thrombosis include hypotension, torsion or kinking of the vessels, trauma to the donor artery unrecognized intimal injury during organ procurement, hypercoagulable. Renal vascular thrombosis in the newborn springerlink. Renal vein thrombosis can be either from bland thrombus or tumor thrombus extension of tumor into the vein.
Common causes include nephrotic syndrome, primary hypercoagulability disorders, malignant renal tumors, extrinsic compression, trauma, and rarely inflammatory. We present our experience with percutaneous rheolytic treatment with the angiojet thrombectomy catheter for acute renalartery thrombosis case report. Renal artery stenosis and occlusion genitourinary disorders. In 1942, campbell4 re ported the first case in which a preopera tive diagnosis of renal vein thrombosis was made and the patient cured by nephrectomy. Aug 24, 2009 renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. Thrombolysis may be an effective treatment to save renal transplants up to 24 hours after arterial occlusion. In this chapter, we explore two categories of emergencies involving the major renal vasculature. Early recognition of the syndrome and proper therapy may. Get a printable copy pdf file of the complete article 321k, or click on a page image below to browse page by page. Causes include embolus to the kidney, in situ thrombosis of the renal artery, renal artery dissection, and iatrogenic thrombosis after endovascular interventions. The extent of renal clearance varies and of the absorbed unchanged drug, the kidneys are responsible for clearance of 80% of dabigatran, 50% of edoxaban, 33% of rivaroxaban, and 27% of apixaban. We propose the use of the angiojet thrombectomy catheter for the percutaneous treatment of acute renal artery thrombosis.
The syndrome is responsible for a hypercoagulable state. Treatment of a renal artery thrombosis depends on the type acute or chronic of thrombosis, and the length of time since the thrombosis occurred. Request pdf a case of renal artery thrombosis with renal infarction renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. Neonatal renal vascular thrombosis is rare but has devastating sequelae. Bilateral renal artery thrombosis secondary to acute. Arterial thrombosis in a renal transplant is a major complication that usually leads to graft loss. Left renal arteriography demonstrated absence of left renal artery flow. Common causes include nephrotic syndrome, primary hypercoagulability disorders, malignant renal tumors, extrinsic compression, trauma, and rarely inflammatory bowel disease. It is not my intention to question the relation between such medication and the development of thrombosis, but i wish to comment on the authors statement that spontaneous renal artery thrombosis has not been previously described in the absence of trauma. With mdct, we made the diagnosis within hours of presentation even though ultrasound findings. In the arterial phase of contrast enhanced thoracoabdominal ct, the presence of thrombosis and no contrast enhancement in the left renal artery was detected. Acute renal artery thrombosis is a devastating complication of renal transplantation that can result in graft loss if not detected early. Renal artery stenosis symptoms and causes mayo clinic.
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