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. Renal artery thrombosis renal artery thrombosis is the formation of a clot in a renal artery. However, thrombus formation may be delayed until after the first week 3. Either thromboemboli or in situ thrombi may cause complete occlusion of the main renal artery or smaller segmental branch arteries 1,7. 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. Links to pubmed are also available for selected references. Successful percutaneous renal intervention in a patient with. Apr 22, 2002 renal artery thrombosis or embolus is a rare condition that may lead to hypertension and renal failure. 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. Neonatal renal vascular thrombosis is rare but has devastating sequelae. A 66yearold female presented with abdominal pain and acute kidney injury aki.
Causes include embolus to the kidney, in situ thrombosis of the renal artery, renal artery dissection, and iatrogenic thrombosis after endovascular interventions. Renal artery thrombosis as a complication of umbilical arterial catheterisation is a common cause of neonatal hypertension. Renal artery stenosis symptoms and causes mayo clinic. Bilateral renal artery thrombosis secondary to acute. Renal artery thrombosis is a rare, but serious and often underdiagnosed condition. Diagnosis and management of renalartery thrombosis. Well tell you about these clots, how to diagnose them, and treatment options. Possible causes for thrombosis include hypotension, torsion or kinking of the vessels, trauma to the donor artery unrecognized intimal injury during organ procurement, hypercoagulable. With mdct, we made the diagnosis within hours of presentation even though ultrasound findings were normal. 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. Renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. Early recognition of the syndrome and proper therapy may. Apr 20, 2011 renal vein thrombosis is the occlusion of one or both renal veins.
Acute renal artery thrombosis treated by percutaneous. Blood clotting where it shouldnt or when you dont want it to. Jul 15, 2015 neonatal renal vascular thrombosis is rare but has devastating sequelae. Case report endovascular revascularization for isolated. 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. It may be associated with other thromboembolism, including pulmonary embolism. In a series of over 14,000 autopsies, about 200 cases of kidney infarction were identified a prevalence of 14. The syndrome is responsible for a hypercoagulable state. Followup renal angiogram at 1 week c and 2 weeks d showed significantly improved renal perfusion.
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. Renal artery stenosis and occlusion genitourinary disorders. 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. New thrombolytic infusion application of dissolving renal. Renal artery occlusion is a complete blockage of blood flow through one or both of the main renal arteries or its branches. Traumatic renal artery occlusion usually occurs in the left side and mostly seen before the age figure 1. 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. Full textfull text is available as a scanned copy of the original print version. 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. What are the potential etiologies of renal artery thrombosis after renal transplantation when there is no evidence of rejection on the.
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. With the availability of modern angiographic technics, it has become a simple matter to establish the diagnosis of thrombosis of the renal veins. Renal vein thrombosis genitourinary disorders merck. Common causes include nephrotic syndrome, primary hypercoagulability disorders, malignant renal tumors, extrinsic compression, trauma, and rarely inflammatory. Golbus and colleagues report a case of renal artery thrombosis secondary to oral contraceptives 1. As it expands, it compresses the plaque against the artery walls, reopening the vessel for blood to flow through. Although ocps have been strongly associated with venous thrombosis, we report left accessory renal artery thrombosis leading to acute. 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 infarction is a rare condition with a reported incidence of 0.
A 63yearold male patient with renalartery thrombosis presented 48 hours after the onset of acute nonradiating flank pain. Treatment of a renal artery thrombosis depends on the type acute or chronic of thrombosis, and the length of time since the thrombosis occurred. Predisposing factors include small dacron grafts, renal atrophy associated with thinwalled diseased arteries and high intrarenal vascular resistance, hypotension, and hypovolemia. Acute renal artery thrombosis after kidney transplantation. In most cases, there is no specific way to prevent renal vein thrombosis. Renal artery thrombosis or embolus is a rare condition that may lead to hypertension and renal failure. Feb, 2018 renal artery stenosis may cause no signs or symptoms until the condition reaches an advanced state. Aug 24, 2009 renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. Acute renal arterial thrombosis, renal artery occlusion nephrology abrupt occlusion of ra which, if complete, may cause permanent renal failure. The patient was released from the hospital with a patent renal unit and ameliorated serum creatinine concentration. 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.
Mechanisms of thrombosis maureane hoffman, md, phd professor of pathology. The clinical manifestations of renal artery thrombosis are as yet not well recognized and therefore not thought of. Renal artery thrombosis thrombosis of renal artery. Aug 31, 2018 the chimneyperiscope technique has been used to address complex aortic pathologies. Once the artery is open, the physician may insert a stent at the site to keep the artery open and support the arterial wall.
Get a printable copy pdf file of the complete article 321k, or click on a page image below to browse page by page. The chimneyperiscope technique has been used to address complex aortic pathologies. Most people with renal artery stenosis have no signs and symptoms. Evolving treatments for arterial and venous thrombosis. Renal artery occlusion wright 2001 bju international. The diagnosis of acute rao is challenging as the disease is rare and the. Percutaneous rheolytic thrombectomy for treatment of acute. We propose the use of the angiojet thrombectomy catheter for the percutaneous treatment of acute renal artery thrombosis. With mdct, we made the diagnosis within hours of presentation even though ultrasound findings. Common causes include nephrotic syndrome, primary hypercoagulability disorders, malignant renal tumors, extrinsic compression, trauma, and rarely inflammatory bowel disease.
The condition is sometimes discovered incidentally during testing for some other reason. We present our experience with percutaneous rheolytic treatment with the angiojet thrombectomy catheter for acute renalartery thrombosis case report. Renal artery thrombosis an overview sciencedirect topics. The renal vein is more commonly affected than the renal artery. Request pdf a case of renal artery thrombosis with renal infarction renal artery thrombosis is a rare, but serious and often misdiagnosed, condition. 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. Treatment options in the past have had limited success. Diagnosis and management of renalartery thrombosis report. Thrombolysis may be an effective treatment to save renal transplants up to 24 hours after arterial occlusion. Renal vascular thrombosis in the newborn springerlink.
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. 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. In this chapter, we explore two categories of emergencies involving the major renal vasculature. If spontaneous renal artery thrombosis is not diagnosed early and is not treated properly, it results in. Most cases of renal allograft thrombosis occur early in the postoperative period with a peak incidence of 48 h. The diagnosis of renal artery occlusion was made on contrastenhanced ct cect and confirmation of etiology was made only on post mortem ncbi. Surgical and technical errors are the major cause of renal artery thrombosis. Case report oral contraceptive causing renal artery. Few cases of thrombosis of the renal artery have been reported in the literature. Renal artery stenosis is a decrease in blood flow through one or both of the main renal arteries or their branches. In carefully selected patients, renal angioplasty improves blood pressure and kidney function with minimal risk. The cause for renal artery thrombosis in renal allograft patients is multifactorial. Pdf acute transplant renal artery thrombosis due to.
Acute renal artery occlusion rao is an uncommon disease that carries the signi. Apr 20, 2002 the cause for renal artery thrombosis in renal allograft patients is multifactorial. Renal vein thrombosis can be either from bland thrombus or tumor thrombus extension of tumor into the vein. Thrombosis was documented by ct angiography, 99m tcdtpa, and digital subtraction. We report a case of bilateral renal artery thrombosis secondary to acute necrotizing pancreatitis. Renal artery thrombosis definition of renal artery. 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. Aspirin is sometimes used to prevent renal vein thrombosis in people who have had a kidney transplant.
We present a case of acute renal artery thrombosis due to disseminated zygomycosis in a healthy young adult male. Blood thinners such as warfarin may be recommended for some people with chronic kidney disease. Practically all the cases reported are those found a. Renal artery thrombosis in a young woman taking oral. Doacs are cleared through renal and extrarenal pathways. Intrathrombic urokinase reverses neonatal 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. Pdf acute transplant renal artery thrombosis due to distal. There are numerous etiologies for bland thrombus, but it most commonly occurs in the hypercoagulable nephrotic syndrome. It is not my intention to question the relation between such medication and the development of thrombosis, but i wish to comment on. Keeping enough fluids in the body may help reduce risk. There has been a relative increase in its diagnosis with the help of advanced imaging techniques, such as computed tomography ct 2. In acute situations, thrombolytic clotbusting medication may be infused into the renal artery for several hours to several days to break up the clot. Renal artery thrombosis is a rare complication with an incidence of 1%, usually the consequence of technical problems during surgery. 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.
Renal artery thrombosis and ischaemia presenting as severe. Acute renal artery thrombosis is a devastating complication of renal transplantation that can result in graft loss if not detected early. Arterial thrombosis in a renal transplant is a major complication that usually leads to graft loss. Case report endovascular revascularization for isolated renal. 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. A thrombosis of a renal artery may cause kidney failure because of blocked blood flow to the kidney. 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. Your doctor may also suspect a problem if you have. Acute posttraumatic bilateral renal artery thrombosis is a rare phenomenon and has been sparsely described in the literature. The incidence of renal injures increases in preexisting congenital or acquired renal pathology. If spontaneous renal artery thrombosis is not diagnosed early and is not treated properly, it results in renal insufficiency due to renal infarction. Clot propagation to the renal arteries may result in renal.
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. Stenosis and occlusion are usually due to thromboemboli, atherosclerosis, or fibromuscular dysplasia. Left renal arteriography demonstrated absence of left renal artery flow. Spontaneous thrombosis of the renal artery is a rare event. The largest case series of emergency department patients give a prevalence of 0. Since then, numerous addi tional reports concerning renal vein thrombosis in infants and.
Ask the experts etiology of renal artery thrombosis in renal. Renal vein thrombosis is thrombotic occlusion of one or both main renal veins, resulting in acute kidney injury or chronic kidney disease. 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. Get a printable copy pdf file of the complete article 2. Oct 23, 2017 renal vein thrombosis rvt is a blood clot that forms in the renal vein. A case of renal artery thrombosis with renal infarction. In the arterial phase of contrast enhanced thoracoabdominal ct, the presence of thrombosis and no contrast enhancement in the left renal artery was detected. 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. Successful percutaneous renal intervention in a patient.
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