Renal arteriography with endovascular ultrasound for the management of renal infarction patients.

Abstract:

BACKGROUND:Renal infarction (RI) is a rare disease with poor prognosis. Appropriate secondary prevention treatment is essential and requires an exhaustive etiological assessment. We aimed to determine whether invasive endovascular explorations may improve the diagnostic process and change the secondary prevention treatment strategy in RI patients. METHODS:We report a retrospective observational study of 25 RI patients referred to Tours University Hospital between 2011 and 2018 for etiological investigation including renal arteriography and intravascular ultrasonography (IVUS). We sought for antithrombotic treatment regimen, vital status, bleeding and ischemic outcomes during the median follow-up of 59 months. RESULTS:Invasive explorations showed local arterial disease in 14 patients (56%). This led to a diagnosis or change in diagnosis in 9 patients (36%) and to a change in antithrombotic strategy in 56% of cases, with an increased prescription of antiplatelet therapy. No patient died, only two patients (8%) had persistent mild renal insufficiency. One IVUS complication was reported and treated without any significant long-term consequences. CONCLUSION:Invasive endovascular investigations of RI may modify the secondary prevention treatment through a better assessment of the aetiology of RI. Multicentric randomized studies are necessary to advocate the hypothesis that invasive exploration of renal artery can improve long-term prognosis.

journal_name

BMC Nephrol

journal_title

BMC nephrology

authors

Ivanes F,Dewaele J,Touboul C,Gatault P,Sautenet B,Barbet C,Büchler M,Quilliet L,Angoulvant D,Halimi JM

doi

10.1186/s12882-020-01929-z

subject

Has Abstract

pub_date

2020-07-14 00:00:00

pages

273

issue

1

issn

1471-2369

pii

10.1186/s12882-020-01929-z

journal_volume

21

pub_type

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