Traumatic Renal Artery Occlusion: A 15-Year Review

Haas, Christopher A.; Dinchman, Kurt H.; Nasrallah, Phillip F.; Spirnak, J. Patrick

doi:10.1016/s0022-5347(01)61893-7

Cited by 24 publications

(51 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The same is applicable to pediatric patients. Haas et al [5] in their series of 12 cases had three pediatric patients. In all three, revascularization was attempted, but resulted in nephrectomies in two and a differential function of <10% in one who later developed hypertension.…”

Section: Discussionmentioning

confidence: 98%

“…[4] A review of the literature showed very few pediatric patients with traumatic renal artery injury. Haas et al, [5] in their series of 12 cases, had three pediatric patients. In another large series, by Elliott et al, [6] no patient in the pediatric age group sustained main renal artery injury.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10] The described mechanisms of injury that result in traumatic renal injury are acceleration/ deceleration injury of the comparatively fixed renal vascular pedicle, compression of the renal artery against the vertebral bodies of the spine, giving rise to intimal damage of the vessel and thrombosis, and sometimes injury by fractured rib segments. [5] Traumatic renal arterial thrombosis almost never occurs as an isolated event and indicates major associated injuries. [3] The information on the physical examination is insufficient to establish a diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…About 25-50% of the patients will develop hypertension; most patients who develop renovascular hypertension do so within the fist year, with a mean of 96 days. [5] These patients may need delayed nephrectomy. However, the incidence of hypertension is less in pediatric cases of renal artery occlusion.…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Traumatic renal artery occlusion in the pediatric age group: a case and review of the literature

Garge¹,

Kanojia²,

Rao³

2013

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

Blunt trauma represents a major cause of death in children. The incidence of renal arterial injuries in these cases is less than 1%. Traumatic renal artery occlusion is a rare occurrence in the pediatric age group. However, there is lack of information on the exact incidence and results of the management of these rare cases in the pediatric age group. We report herein a case and we review the available literature of this severe injury in the pediatric age group.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic renal artery occlusion in the pediatric age group: a case and review of the literature

Garge¹,

Kanojia²,

Rao³

2013

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

“…Open efforts to revascularize the kidney seldom have successful outcomes. 2,5,6 Traditionally, main renal artery injuries in grade V renal trauma are associated success rates of 0% to 25% after attempted salvage. 2,4,6 Endovascular stenting in the setting of renal artery injury has shown promise as an alternative to open surgery.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Management of Trauma Related Renal Artery Thrombosis

Breyer

Master²,

Marder³

et al. 2008

Journal of Trauma: Injury, Infection &Amp; Critical Care

View full text Add to dashboard Cite

Patients with grade IV or V renal injury frequently have associated visceral injuries that can limit options such as open surgical repair or anticoagulation. 1 The use of endovascular stents to treat trauma-induced renal artery thrombosis and intimal damage appears promising. 2,3 However, data verifying the effectiveness of the treatment is lacking. We present a case of acute renal artery revascularization after trauma with subsequent stent thrombosis. Our case illustrates the failure of stent therapy when anticoagulation is not possible. CASE REPORTA 43-year-old female motorcyclist sustained blunt trauma and presented with abdominal, chest, and extremity pain. Physical examination was significant for an acutely tender abdomen. Serum chemistries and hematocrit were within normal limits. Gross blood was not present on Foley catheter insertion, but urinalysis revealed microscopic hematuria. A computed tomography scan showed the right kidney was nonperfused; indicating a grade V injury (Fig. 1). No perinephric hemorrhage or retroperitoneal fluid was noted. In addition, a grade IV liver injury and a grade I splenic laceration were present. After consultation between the urology, trauma, and interventional radiology service, a laparotomy was deemed inadvisable because of the likelihood of massive liver bleeding. A diagnostic angiography, however, showed no active extravasation from the liver and an abrupt cut off of the injured right renal artery (Fig. 2). A hydrophilic guidewire was used to cross the thrombosed vessel. Two overlapping Cordis Genesis PG244B stents (Johnson and Johnson, Warren, N.J.) were deployed on a high-pressure angioplasty balloon. Repeat angiography revealed restored blood flow to the kidney with no residual intraluminal defect (Figs. 3 and 4). The hepatic and splenic injuries were managed nonoperatively. Given this concomitant trauma, no anticoagulation or antiplatelet therapy was initiated after stent placement. On postoperative day three, the patient's serum creatinine doubled. Renal ultrasound demonstrated an absence of flow to the right renal artery. The patient's creatinine peaked at 2.8 and later normalized to 1.2. A 1-month follow-up computed tomography scan and lasix MAG-3 renal scan, respectively, showed patchy contrast uptake and 5% relative function in the stented kidney.

show abstract

Grade IV Renal Injuries: Evaluation, Treatment, and Outcome

Santucci

McAninch

2001

World j. surg.

View full text Add to dashboard Cite

Of our last 2483 renal trauma patients, 113 had grade IV injuries. In most the mechanism was a penetrating injury (60%: 30% gunshot, 30% stab wounds). Associated injuries were common (80%) and hospital stays prolonged, averaging 16 days. Most of the patients (70%) required transfusion, some massively (average volume 4.4 liters, range 0-30 liters). Surprisingly, not all patients with grade IV renal injuries had gross hematuria: 25% had microhematuria, and 4% had neither microscopic nor gross hematuria. Computed tomography (CT) diagnosed the injury correctly in 100% of the patients in whom it was performed; when CT was not available, "one-shot" intraoperative intravenous pyelography (IVP) demonstrated grossly abnormal findings in 90%. Renal exploration was performed in 78%, resulting in 69% renorrhaphy and 9% nephrectomy rates in our 113 patients. Almost all those with penetrating trauma required exploration (97%), whereas only 50% of those with blunt trauma did so. The overall complication rate and kidney-specific complication rate did not differ significantly between patients who were observed and those who underwent surgery. Complications rates were similar in grade IV renal laceration patients and grade III patients. Delayed complications after hospital discharge were not seen, although follow-up was rare in this inner-city trauma population. Among the 21% of patients in whom postoperative nucleotide renal function scans were available, function was generally good (average 36%). Only patients who underwent concomitant vascular repair had poor function (below 20%).

show abstract

Traumatic Renal Artery Occlusion: A 15-Year Review

Cited by 24 publications

References 0 publications

Traumatic renal artery occlusion in the pediatric age group: a case and review of the literature

Traumatic renal artery occlusion in the pediatric age group: a case and review of the literature

Endovascular Management of Trauma Related Renal Artery Thrombosis

Grade IV Renal Injuries: Evaluation, Treatment, and Outcome

Contact Info

Product

Resources

About