Treatment of Renal Artery Embolism

Nicholas, Gary G.; DeMuth, William E.

doi:10.1001/archsurg.1984.01390150020005

Cited by 30 publications

(6 citation statements)

References 20 publications

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“…In the first few days, elevation of serum LDH and GOT may be detected and fever with a marked leukocytosis may be present [1], A patient, especially a younger one, presenting uncharac teristic flank pain despite a normal renal sonography, nor mal urinalysis, and no evidence of stone formation on the plain film should be checked for renal vascular condition. To evaluate renal artery embolism, selective renal arteri ography is necessary, but radioisotope scanning can also be helpful [3].…”

Section: Discussionmentioning

confidence: 99%

“…The time of warm ischemia which is tolerated without irreversible renal damage is almost 60 min [5], However, successful revascularization after several hours or several days depends on the collater al blood supply. Treatment modalities are surgical remov al of embolus and fibrinolytic therapy [ 1 ]. The main tech nique of the latter has been regional arterial infusion of streptokinase [6] or urokinase [7].…”

Section: Discussionmentioning

confidence: 99%

“…Acute thrombosis of renal artery often occurs in pa tients with atherosclerotic cardiovascular diseases or atrial Fibrillation [1], but its diagnosis and successful treat ment are not so easy. Acute thrombosis of bilateral renal arteries causes acute renal failure, and treatment for this condition is only revascularization by surgical extraction or Fibrinolysis of thrombus.…”

Section: Introductionmentioning

confidence: 99%

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Successful Fibrinolytic Therapy Using Tissue Plasminogen Activator in Acute Renal Failure due to Acute Thrombosis of Bilateral Renal Arteries

Takeda

Katayama²,

Takahashi³

et al. 1993

Urol Int

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A 46-year-old housewife with regurgitation of mitral valve developed acute renal failure due to acute thrombosis of bilateral renal arteries after cardiac catheterization. A regional fibrinolytic therapy using transarterial infusion of tissue plasminogen activator (t-PA) was performed at 8 h after the onset, and was successful. She could be taken off hemodialysis 2 weeks after the fibrinolytic therapy, and could be successfully operated on with mitral valve replacement 7 months after that. Three years after mitral valve replacement, her serum creatinine was 148µmol/l. This is the longest follow-up case after regional transarterial flbrinolysis of acute thrombosis of renal artery using t-PA, and this therapy is a safe and good one for acute thrombosis of renal artery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Successful Fibrinolytic Therapy Using Tissue Plasminogen Activator in Acute Renal Failure due to Acute Thrombosis of Bilateral Renal Arteries

Takeda

Katayama²,

Takahashi³

et al. 1993

Urol Int

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“…ARI should be diagnosed within the first 4 h after symptom onset to ensure the feasibility of using thrombolysis with intra-arterial urokinase [11] . Ideally, ARI should be diagnosed within the first 90 min of symptom onset [12] , a situation that rarely occurs [13,14] . Many studies have reported favourable results using anticoagulants (unfractionated heparin, low-molecular-weight heparin and warfarin) in the treatment of ARI [3,13] .…”

Section: Case Historymentioning

confidence: 99%

Epigastric Pain in Acute Renal Infarction: The Forgotten Presentation

Maadarani¹,

Bitar²

2015

European Journal of Case Reports in Internal Medicine

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Epigastric pain is a manifestation of several medical and surgical conditions. However, when persistent epigastric pain is associated with microscopic or frank haematuria and elevated lactate dehydrogenase (LDH), especially in patients with increased risk of thromboembolic events, acute renal infarction (ARI) should be considered. We report the case of a 77-year-old male patient who presented with sudden persistent epigastric pain and elevated LDH who was found to have atrial fibrillation. The patient was diagnosed with ARI. ARI is not usually a typical differential diagnosis in patients with persistent epigastric pain and elevated LDH in whom the risk of thromboembolic events is high. Thus, physicians should perform a contrast-enhanced CT scan as early as possible to rule out or confirm renal infarction. LEARNING POINTS • In acute kidney infarction, epigastric pain can be one of the clinical manifestations. • The combination of unexplained epigastric pain and elevated lactate dehydrogenase and haematuria in a patient with an increased risk of thromboembolic events should raise the suspicion of acute kidney infarction. • The physician should perform a contrast-enhanced CT scan as early as possible to rule out or confirm kidney infarction.

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“…Three years after the op eration, her serum Cr was maintained atis tolerated without irreversible renal damage is almost 60 min [2]. Treatment modalities of acute thrombosis of the reanl artery are surgi cal removal of the embolus and fibrinolytic therapy [3]. Recently, recombinant t-PA has been developed and has been used for acute thrombosis of the coronary artery by in travenous administration, t-PA is a synthetic fibrinolytic protein which activates plasmi nogen or converse plasminogen to plasmin specifically in the presence of fibrin.…”

Section: I Ii I I I Imentioning

confidence: 99%