Renal artery emboli: the role of surgical treatment.

Abstract:

:Twelve cases of emboli to the renal artery (one of which was recurrent) were reviewed. In seven patients, emboli were unilateral and the opposite kidney was functional. In five patients, emboli were bilateral or occurred in a solitary kidney, leading to anuria. Cardiac rhythm disorders were encountered in eight patients and were responsible for emboli in other areas in three. Arteriography in ten patients demonstrated seven complete truncal occlusions (one bilateral), two incomplete truncal occlusions, and one distal embolus. One patient with a distal embolus was treated by heparin alone with satisfactory results. One patient in poor general condition was treated with intraarterial streptokinase, resulting in incomplete lysis of the clot. The five patients with anuria were operated on: four regained satisfactory renal function whereas the other patient died. In five patients without anuria who were operated upon, renal function returned to normal in four, and one patient required nephrectomy. Surgical treatment is imperative with anuria and is indicated in unilateral emboli with a functional contralateral kidney, especially when there is complete occlusion of the renal trunk. If the embolus is recent, intraarterial fibrinolytic treatment or percutaneous embolectomy can be attempted, but these techniques are not of proven efficacy. Patients with distal emboli or contraindications to operation should be treated by anticoagulant therapy, alone or with local fibrinolytic treatment.

journal_name

Ann Vasc Surg

authors

Bouttier S,Valverde JP,Lacombe M,Nussaume O,Andreassian B

doi

10.1016/S0890-5096(06)60800-5

subject

Has Abstract

pub_date

1988-04-01 00:00:00

pages

161-8

issue

2

eissn

0890-5096

issn

1615-5947

pii

S0890-5096(06)60800-5

journal_volume

2

pub_type

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