Successful Percutaneous Renal Intervention in a Patient With Acute Traumatic Renal Artery Thrombosis

Isolated Renal Artery Thrombosis because of Blunt Trauma Abdomen: Report of a Case with Review of the Literature

“…Successful percutaneous revascularization has been performed by using a balloon occlusive distal protection device. Faster procedure and lesser morbidity than thrombolysis or surgical revascularization are the main advantage highlighted by the authors [16] . Relative efficacies of different revascularization options for blunt traumatic RAT are not known and have not been compared so far.…”

“…Bilateral involvement is an even rarer finding [13] . Until now less than 400 cases are on record in the literature [14] , but the incidence appears to be increasing probably because of the liberal use of the CT scan in the management of the abdominal trauma [15,16] . The most recent prospective case series of RAT has found an incidence of 0.1% of all BTA admissions at a single institute over 3 years [17] .…”

“…Although the optimal treatment of this condition has not been well established [6] , trends have definitely moved towards renal preservation whenever possible by revascularization. Table 1 also shows that revascularization can be either performed surgically or more preferably by percutaneous means (mainly because of minimal invasiveness) in cases of both unilateral and bilateral traumatic RAT, although the evidence for this sort of management comes from case reports [6,16] . However, in case of failure of revascularization and development of potential complications of conservative management (mainly hypertension), nephrectomy may be the only reliable option left [7,21] , which is also recommended when renal function is completely lost and autonephrectomy has not occurred even after a long time of observation.…”

Renal artery thrombosis due to blunt trauma: case report

“…On the other hand, aggressive renal revascularization is indicated for treatment of bilateral renal artery occlusion or unilateral occlusion in a solitary kidney regardless of time delay, unless the patient is unstable and surgical intervention means prolonging surgery and endangering patient life to save some of the renal function. Patients who are managed expectantly without revascularisation require close monitoring for onset of hypertension and possible renal failure (3,9) . In our case, surgical revascularization was not considered, because the ischemic time was longer than the suggested 24 hours.…”

“…Immediate intervention is important to preserve renal functions. When surgical management or thrombolytics are not plausable, percutaneous transluminal angioplasty (PTA) can be a safe option (3) . We are presenting a case of traumatic complete left renal artery thrombosis and partial right renal artery occlusion that was treated by PTA.…”