1
|
Diamantopoulos-Kogkas D, Georgiou P, Pitros C, Papageorgopoulou C, Papasotiriou M, Karydis N, Koutsoyiannis N, Mougiou A, Katsanos K, Papadoulas S. Vacuum-Assisted Thrombo-Aspiration for Paradoxical Embolism in Left Renal Artery: A Case Report and Literature Review. Vasc Specialist Int 2024; 40:21. [PMID: 38915224 PMCID: PMC11196943 DOI: 10.5758/vsi.240022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/17/2024] [Accepted: 03/27/2024] [Indexed: 06/26/2024] Open
Abstract
Paradoxical embolism through the foramen ovale is a rare and devastating event requiring urgent treatment. Herein, we present the case of a 23-year-old male who presented with a pulmonary embolism complicated by a left renal artery paradoxical embolism. Urgent vacuum-assisted thrombo-aspiration restored normal perfusion of the left kidney within 5 hours. The patient had a patent foramen ovale and heterozygous thrombophilia. However, a radioisotopic scan performed 2 years later revealed an unexpected decrease in left renal perfusion. Therefore, despite the angiographic success, functional evaluation using a renal scan should be performed to assess renal function.
Collapse
Affiliation(s)
| | - Pavlos Georgiou
- Department of Vascular Surgery, University General Hospital of Patras, Patras, Greece
| | - Christos Pitros
- Department of Vascular Surgery, University General Hospital of Patras, Patras, Greece
| | | | - Marios Papasotiriou
- Department of Nephrology and Kidney Transplantation, University General Hospital of Patras, Patras, Greece
| | - Nikolaos Karydis
- Department of Transplantation Surgery, Department of Surgery, University General Hospital of Patras, Patras, Greece
| | | | - Athina Mougiou
- Division of Thrombophilic Disorders, Department of Haematology, University General Hospital of Patras, Patras, Greece
| | - Konstantinos Katsanos
- Department of Interventional Radiology, University General Hospital of Patras, Patras, Greece
| | - Spyros Papadoulas
- Department of Vascular Surgery, University General Hospital of Patras, Patras, Greece
| |
Collapse
|
2
|
Weise L, Chiapaikeo D, Tan TW, Weinkauf C, Goshima KR, Zhou W. Role of late renal revascularization in functional renal salvage. J Vasc Surg Cases Innov Tech 2022; 8:121-124. [PMID: 35243188 PMCID: PMC8857538 DOI: 10.1016/j.jvscit.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/17/2021] [Indexed: 11/17/2022] Open
Abstract
The duration that renal parenchyma will tolerate ischemia has continued to be debated. We have reported the cases of three patients who had undergone revascularization procedures with successful return of baseline renal function after prolonged renal artery occlusion of 14 days to 3 months. These cases highlight that aggressive revascularization can lead to successful renal salvage in selected patients. We examined the characteristics of these patients and those of others in the literature and reviewed the factors favoring recovery.
Collapse
Affiliation(s)
| | | | | | | | | | - Wei Zhou
- Correspondence: Wei Zhou, MD, Division of Vascular Surgery, Department of Surgery, University of Arizona, 1601 N Campbell Ave, Tucson, AZ 85724
| |
Collapse
|
3
|
Lemiński A, Kubis M, Kaczmarek K, Gołąb A, Kazimierczak A, Kotfis K, Słojewski M. When Bodybuilding Goes Wrong—Bilateral Renal Artery Thrombosis in a Long-Term Misuser of Anabolic Steroids Treated with AngioJet Rheolytic Thrombectomy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042122. [PMID: 35206310 PMCID: PMC8872588 DOI: 10.3390/ijerph19042122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 02/04/2023]
Abstract
Bilateral renal infarction is an extremely rare condition with only few cases reported in the literature. We present a case of bilateral renal infarction affecting an otherwise healthy 34 year old bodybuilder chronically misusing testosterone and stanozolol. The patient presented with severe flank pain mimicking renal colic and biochemical features of acute kidney injury. Diagnostic workup revealed thrombosis affecting both renal arteries. Subsequently, the patient underwent a percutaneous rheolytic thrombectomy with AngioJet catheter, along with catheter-directed thrombolysis. Right-sided retroperitoneal hematoma developed as an early complication, mandating surgical exploration and nephrectomy due to kidney rupture and the unstable condition of the patient. Intensive care and continuous renal replacement therapy were instigated until a gradual improvement of the patient status and a return of kidney function was achieved. No abnormalities were found in the cardiological and hematological evaluation. We believe this is a first report of bilateral renal infarction associated with anabolic steroid misuse in an otherwise healthy individual, and a first report of AngioJet thrombectomy in bilateral thrombosis of renal arteries. It stresses the importance of a thorough diagnostic workup of colic patients and emphasizes the need for sports medicine to reach out to amateur athletes with education on the harms of doping.
Collapse
Affiliation(s)
- Artur Lemiński
- Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.K.); (K.K.); (A.G.); (M.S.)
- Correspondence: (A.L.); (K.K.)
| | - Markiian Kubis
- Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.K.); (K.K.); (A.G.); (M.S.)
| | - Krystian Kaczmarek
- Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.K.); (K.K.); (A.G.); (M.S.)
| | - Adam Gołąb
- Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.K.); (K.K.); (A.G.); (M.S.)
| | - Arkadiusz Kazimierczak
- Department of Vascular Surgery and Angiology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland;
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland
- Correspondence: (A.L.); (K.K.)
| | - Marcin Słojewski
- Department of Urology and Urological Oncology, Pomeranian Medical University, al. Powstańców Wlkp. 72, 70-111 Szczecin, Poland; (M.K.); (K.K.); (A.G.); (M.S.)
| |
Collapse
|
4
|
Kolachana SM, Janvier A. Acute Renal Infarction Heralds New-Onset Paroxysmal Atrial Fibrillation. Cureus 2022; 14:e21554. [PMID: 35223324 PMCID: PMC8865364 DOI: 10.7759/cureus.21554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/05/2022] Open
|
5
|
Kishikawa R, Tanaka T, Hashimoto M, Honda K, Omori Y, Ishihara A, Kamoi Y. Percutaneous Catheter Thrombus Aspiration of Right Renal Infarction Caused by Left Ventricular Thrombi due to Takotsubo Cardiomyopathy. Int Heart J 2020; 61:400-403. [PMID: 32173705 DOI: 10.1536/ihj.19-447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Takotsubo cardiomyopathy (TC) is a temporal dysfunction of the left ventricle (LV) due to psychological or physiological stress; however, it rarely causes LV thrombus. We report a case of a 49-year-old woman who developed LV thrombi due to TC despite anticoagulation therapy. The thrombi caused acute systemic infarction, with the most severe occlusion being in the right renal artery. The patient underwent percutaneous catheter aspiration thrombectomy of the right renal artery and her renal function recovered shortly after. The results of this case suggest that catheter aspiration thrombectomy is effective in the treatment of thromboembolism in TC.
Collapse
Affiliation(s)
| | | | | | - Kei Honda
- Department of Cardiology, Showa General Hospital
| | | | | | | |
Collapse
|
6
|
Fiorucci B, Isernia G, Simonte G, Farchioni L, Parente B, Parlani G, Lenti M. Rheolytic Thrombectomy with AngioJet ® Is Safe and Effective in Revascularization of Renal Arteries' Acute Occlusion on Previous Complex Aortic Endovascular Repair. Ann Vasc Surg 2017; 45:270.e1-270.e6. [PMID: 28739460 DOI: 10.1016/j.avsg.2017.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 06/19/2017] [Accepted: 07/14/2017] [Indexed: 11/29/2022]
Abstract
Acute occlusion of the visceral arteries is a threatening complication following branched endovascular aortic repair (EVAR). Its prompt diagnosis and treatment are mandatory to restore renal function. Several techniques have been used to manage this complication. We report 2 clinical cases of patients, previously treated with implantation of an off-the-shelf thoracoabdominal aortic endograft, with acute bilateral occlusion of the renal arteries. Both patients were successfully treated with AngioJet rheolytic thrombectomy. Acute occlusion of the renal arteries can dramatically complicate the outcome of patients treated with branched EVAR. Prompt diagnosis and treatment are required. Rheolytic thrombectomy rapidly removes intra-arterial thrombus through Bernoulli effect, preventing the risk of distal embolization and rapidly restoring the renal function.
Collapse
Affiliation(s)
- Beatrice Fiorucci
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy.
| | - Giacomo Isernia
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Gioele Simonte
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Luca Farchioni
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Basso Parente
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Gianbattista Parlani
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Massimo Lenti
- Department of Vascular Surgery, Unit of Vascular Surgery, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| |
Collapse
|
7
|
Decoste R, Himmelman JG, Grantmyre J. Acute renal infarct without apparent cause: A case report and review of the literature. Can Urol Assoc J 2015; 9:E237-9. [PMID: 26085895 DOI: 10.5489/cuaj.2466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Acute renal infarction is a rare clinical entity most commonly occurring as a result of a thromboembolic event in patients with predisposing risk factors. Its non-specific presentation can lead to delayed or missed diagnosis. However, modern imaging technology has allowed for the diagnosis of renal infarction to be made earlier in its clinical course. Due to its rare nature, treatment guidelines do not exist. We report a case of acute renal infarction identified on computed tomography scan in a patient with no known predisposing factors to thromboembolism that was treated through suction thrombectomy.
Collapse
Affiliation(s)
- Ryan Decoste
- Dalhousie University Medical School, Halifax, NS
| | | | | |
Collapse
|
8
|
Acute renal infarction presenting with acute abdominal pain secondary to newly discovered atrial fibrillation: a case report and literature review. Case Rep Emerg Med 2015; 2014:981409. [PMID: 25614841 PMCID: PMC4295136 DOI: 10.1155/2014/981409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/09/2014] [Indexed: 11/24/2022] Open
Abstract
We report an 85-year-old female with known history of recurrent diverticulitis presented with abdominal pain. It was believed that the patient again needed to be treated for another diverticulitis and was started on the routine treatment. The initial CT scan of abdomen showed renal infarcts bilaterally that were confirmed by a CT with and without intravenous contrast secondary to unknown cause. An ECG found accidentally that the patient was in atrial fibrillation, which was the attributed factor to the renal infarctions. Subsequently, the patient was started on the appropriate anticoagulation and discharged.
Collapse
|
9
|
Percutaneous catheter aspiration thrombectomy for the occluded stents of pulmonary artery in children with single ventricle physiology after fontan surgery. Catheter Cardiovasc Interv 2014; 84:1153-6. [DOI: 10.1002/ccd.25470] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 02/16/2014] [Accepted: 03/01/2014] [Indexed: 11/07/2022]
|
10
|
Summaria F, Mustilli M, Romagnoli E. "Primary" percutaneous transluminal renal angioplasty for late stent thrombosis. Cardiovasc Interv Ther 2013; 29:283-7. [PMID: 24307537 DOI: 10.1007/s12928-013-0230-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 11/22/2013] [Indexed: 10/25/2022]
Abstract
Renal artery thrombosis is a rare, but serious and often misdiagnosed, condition, with poor prognosis and renal functional impairment. As for the rarity of the occurrence, data about real incidence of renal stent thrombosis are lacking, ranging from 0 to 1 % depending on the study evaluated. We report the case of a 43-year-old man with nephrovascular hypertension, previously treated with renal stent implantation, with a late stent thrombosis. The diagnostic and subsequent therapeutic management was analyzed and discussed.
Collapse
|
11
|
First Use of a Drug-Eluting Balloon in the Treatment of Acute Renal Artery Occlusion and In-stent Restenosis. Am J Med Sci 2013; 346:244-6. [DOI: 10.1097/maj.0b013e31828b2b7f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
12
|
Tan TW, Bohannon WT, Mattos MA, Hodgson KJ, Farber A. Percutaneous mechanical thrombectomy and pharmacologic thrombolysis for renal artery embolism: case report and review of endovascular treatment. Int J Angiol 2012; 20:111-6. [PMID: 22654475 DOI: 10.1055/s-0031-1279682] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Renal artery embolism (RAE) is an uncommon event that is associated with a high rate of renal loss. We present a case of RAE to a solitary kidney that was treated with combined percutaneous rheolytic thrombectomy, intra-arterial thrombolysis, and supplemental renal artery stent placement.
Collapse
|
13
|
Komolafe B, Dishmon D, Sultan W, Khouzam RN. Successful aspiration and rheolytic thrombectomy of a renal artery infarct and review of the current literature. Can J Cardiol 2012; 28:760.e1-3. [PMID: 22906801 DOI: 10.1016/j.cjca.2012.06.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 06/10/2012] [Accepted: 06/18/2012] [Indexed: 12/28/2022] Open
Abstract
The use of revascularization techniques including angioplasty, thrombectomy, and stenting in the coronary, cerebral, and peripheral arteries has revolutionized the entire field of endovascular therapeutics. In renal thromboembolism, the classic treatment has been anticoagulation with possible thrombolysis and surgical thrombectomy. The role of endovascular therapy in renal thromboembolism remains controversial. There are a few anecdotal reports about the use of aspiration and rheolytic thrombectomy in the renal arteries. We present a case of acute renal infarction resulting from systemic embolism secondary to atrial fibrillation. This was treated with revascularization, including aspiration and rheolytic thrombectomy, with excellent results.
Collapse
Affiliation(s)
- Babatunde Komolafe
- Department of Medicine, Division of Cardiology, University of Tennessee Health Science Center, 6283 Common Oaks Ct#106, Memphis, TN 38120, USA
| | | | | | | |
Collapse
|
14
|
Emre H, Soyoral YU, Tanik S, Gecit I, Begenik H, Pirincci N, Erkoc R. Can renal infarction occur after renal cyst aspiration? Case report. Kurume Med J 2012; 58:59-61. [PMID: 22251822 DOI: 10.2739/kurumemedj.58.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Renal infarction (RI) is a rarely seen disorder, and the diagnosis is often missed. The two major causes of RI are thromboemboli originhating from a thrombus in the heart or aorta, and in-situ thrombosis of a renal artery. We report a case of RI that developed due to renal artery and vein thrombosis, as confirmed by pathological evaluation of the nephrectomy material, three weeks after renal cyst aspiration.
Collapse
Affiliation(s)
- Habib Emre
- Department of Nephrology, Yuzuncu Yil University, Van 65100, Turkey.
| | | | | | | | | | | | | |
Collapse
|
15
|
Resolution of anuric acute kidney injury after left renal angioplasty and stenting for a totally occlusive in-stent restenosis of a solitary kidney. Am J Med Sci 2010; 341:163-5. [PMID: 21030853 DOI: 10.1097/maj.0b013e3181fb79af] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The authors report a case of unilateral renal artery in-stent occlusion leading to anuric acute kidney injury in a patient with solitary functional kidney. To their knowledge, this is the first reported case of anuric acute kidney injury, which was successfully treated with percutaneous stenting leading to return of renal function to baseline and a prompt resolution of anuria. This case demonstrates that percutaneous revascularization is a safe and feasible treatment option for in-stent occlusion of renal artery supplying a solitary functional kidney and underscores the importance of early recognition and treatment.
Collapse
|
16
|
Acute renal artery thrombosis treated with t-PA power-pulse spray rheolytic thrombectomy. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2010; 11:264.e1-7. [DOI: 10.1016/j.carrev.2009.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2009] [Revised: 10/25/2009] [Accepted: 11/09/2009] [Indexed: 11/24/2022]
|
17
|
Seetho IW, Bungay PM, Taal MW, Fluck RJ, Leung JCH. Renal infarction in patients presenting with suspected renal colic. NDT Plus 2009; 2:362-4. [PMID: 25949343 PMCID: PMC4421373 DOI: 10.1093/ndtplus/sfp074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Accepted: 06/04/2009] [Indexed: 01/24/2023] Open
Abstract
Acute renal infarction is a serious medical emergency. The diagnosis is often delayed or missed as it is not common. Hence, the exact incidence of acute renal infarction is not known. Failure to consider renal infarction in the initial differential diagnosis results in a delay in diagnosis and treatment, which in turn leads to permanent loss of renal function. We present two cases of acute kidney infarction that were initially treated as renal colic. In addition, we present a third case when a kidney was saved with reperfusion therapy.
Collapse
Affiliation(s)
| | - Peter M Bungay
- Department of Interventional Radiology , Derby City General Hospital , Uttoxeter Road, Derby, DE22 2NE , UK
| | | | | | | |
Collapse
|
18
|
Menon SC, Hagler DJ, Cetta F, Cabalka AK. Rheolytic mechanical thrombectomy for pulmonary artery thrombus in children with complex cyanotic congenital heart disease. Catheter Cardiovasc Interv 2008; 71:237-43. [DOI: 10.1002/ccd.21343] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
19
|
Siablis D, Liatsikos EN, Goumenos D, Karnabatidis D, Voudoukis T, Barbalias G, Vlahogiannis J. Percutaneous Rheolytic Thrombectomy for Treatment of Acute Renal-Artery Thrombosis. J Endourol 2005; 19:68-71. [PMID: 15735387 DOI: 10.1089/end.2005.19.68] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE We present our experience with percutaneous rheolytic treatment with the AngioJet thrombectomy catheter for acute renal-artery thrombosis. CASE REPORT A 63-year-old male patient with renal-artery thrombosis presented 48 hours after the onset of acute nonradiating flank pain. Thrombosis was documented by CT angiography, 99mTc-DTPA, and digital subtraction angiography. A percutaneous thrombectomy was performed with the AngioJet catheter. At the end of the procedure, the arterial lumen was patent, and no underlying stenosis or other deformity of the arterial wall was found. Thus, the cause of the obstruction was considered to be an embolus. After the procedure, urokinase was given to prevent distal occlusions from emboli that could have escaped mechanical thrombectomy. Heparin was also administered. The patient was released from the hospital with a patent renal unit and ameliorated serum creatinine concentration. CONCLUSION We propose the use of the AngioJet thrombectomy catheter for the percutaneous treatment of acute renal-artery thrombosis.
Collapse
|
20
|
Di Valentino M, Alerci M, Tutta P, Sartori F, Marone C, Vandoni R, Mahler F, Gallino A. Thrombus aspiration as a bailout procedure during percutaneous renal angioplasty. J Endovasc Ther 2004; 11:522-6. [PMID: 15298510 DOI: 10.1583/03-1196.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To present a case in which thrombus aspiration, urokinase, and abciximab were used to recanalize a sudden acute thrombotic occlusion of the right renal artery during percutaneous renal angioplasty. CASE REPORT A 72-year-old man with severe arterial hypertension, impaired renal function, and peripheral artery disease was referred for interventional renal revascularization of a proximal stenosis of the right renal artery. Predilation was unsuccessful, and stent placement was followed by immediate occlusion of the distal renal artery, probably due to dislocation of a mural thrombus. Since intra-arterial administration of urokinase (300,000 IU) was ineffective, thrombus aspiration was performed using the 7-F guiding catheter. After successful removal of the thrombus, abciximab was given intravenously. Control angiograms showed recanalization of the stented segment and patency of the distal renal arteries, an outcome confirmed 8 months later by duplex ultrasound. CONCLUSIONS As demonstrated in our case, thromboembolic complications can be rapidly and successfully treated on the table by combined measures, such as catheter thrombus extraction and pharmacological strategies.
Collapse
|
21
|
Feng L, Mangla S, Pile-Spellman J. Rheolytic Thrombectomy of Acute Stent Thrombosis of Cervical Vertebral Artery. Interv Neuroradiol 2002; 8:305-12. [DOI: 10.1177/159101990200800311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2002] [Accepted: 08/17/2008] [Indexed: 11/16/2022] Open
Abstract
A new Xpeedior rheolytic thrombectomy catheter has been successfully used to extract thrombus from an acutely thrombosed vertebral artery stent without apparent distal embolism. The ease of use and the speed of thrombectomy suggest that this system may be useful for the treatment of acute ischemic stroke.
Collapse
Affiliation(s)
- L. Feng
- Division of Interventional Neuroradiology, Departments of Radiology, New York Presbyterian Hospital, Columbia University; U.S.A
| | - S. Mangla
- Division of Interventional Neuroradiology, Departments of Radiology, New York Presbyterian Hospital, Columbia University; U.S.A
- Division of Interventional Neuroradiology, Department of Neurosurgery and Neurology, New York Presbyterian Hospital, Columbia University; U.S.A
| | - J. Pile-Spellman
- Division of Interventional Neuroradiology, Departments of Radiology, New York Presbyterian Hospital, Columbia University; U.S.A
- Division of Interventional Neuroradiology, Department of Neurosurgery and Neurology, New York Presbyterian Hospital, Columbia University; U.S.A
| |
Collapse
|