Unilateral Acute Renal Artery Embolism: An Index Case of Successful Mechanical Aspiration Thrombectomy With Use of Penumbra Indigo Aspiration System and a Review of the Literature

Abstract

Acute renal artery embolism (RAE) is a rare condition associated with significant morbidity and mortality. The treatment strategy for RAE includes anticoagulation with or without thrombolysis or surgical or endovascular embolectomy. We describe here a case presentation of acute RAE secondary to atrial fibrillation treated successfully with Penumbra Indigo Aspiration System, a novel device in peripheral endovascular interventions. Our patient had ongoing symptoms and acute renal failure on presentation with contraindication to thrombolysis given hypertensive emergency. A 6F Penumbra Aspiration catheter was used to aspirate large amounts of thrombus from segmental renal arteries with restoration of flow. Patient's symptoms and renal function returned to baseline after intervention. Penumbra system is used routinely in cerebral endovascular intervention, yet here we describe its potential use in peripheral vascular interventions in addition to a literature review of all available evidence for the different treatment modalities of acute RAE.

Vacuum-Assisted Thrombo-Aspiration for Paradoxical Embolism in Left Renal Artery: A Case Report and Literature Review

“…We reviewed English literature on mechanical and pharmacomechanical thrombectomy in patients with renal artery embolisms. We identified nine similar cases (Table 1) [6,[9][10][11][12][13][14][15][16]. Patients with thrombosed renal arteries due to atherosclerosis or hypercoagulable states, thrombosed renal side branches of aortic endografts, occlusion of renal transplant arteries, or aortorenal bypasses were excluded.…”

A rare cause of abdominal pain managed unconventionally: acute renal infarction caused by atrial fibrillation: a case report

“…Diagnosis of ARI is challenging due to its low incidence and nonspecific clinical presentations. Currently, more efficient treatment guidelines are helpful for ARI due to thromboembolic complications of AF [1,2], although aspiration thrombectomy is reported in the treatment of renal artery thromboembolism [3][4][5]. Also, treatment methods employed in prior case reports included systemic thrombolytics, intra-arterial thrombolytics, and systemic anticoagulation [6][7][8].…”

Endovascular Thrombus Aspiration and Catheter-Directed Thrombolysis for Acute Thromboembolic Renal Artery Occlusion

“…1 The diagnosis of ARE is often delayed or ignored due to the rarity and unspecific clinical manifestation of the disease. The treatment options include anticoagulation, 2 with or without thrombolysis, 3 catheter aspiration thrombectomy, 4 or surgical thrombectomy. 5 However, the optimal therapeutic treatment and timing of intervention remain controversial and challenging.…”