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Adam R, Desmettre T. Infarctus rénal révélé par une douleur du flanc. ANNALES FRANCAISES DE MEDECINE D URGENCE 2021. [DOI: 10.3166/afmu-2021-0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ivanes F, Dewaele J, Touboul C, Gatault P, Sautenet B, Barbet C, Büchler M, Quilliet L, Angoulvant D, Halimi JM. Renal arteriography with endovascular ultrasound for the management of renal infarction patients. BMC Nephrol 2020; 21:273. [PMID: 32664890 PMCID: PMC7362568 DOI: 10.1186/s12882-020-01929-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 07/05/2020] [Indexed: 12/14/2022] Open
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.
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Affiliation(s)
- Fabrice Ivanes
- Department of Cardiology, CHRU Tours, Tours, France. .,EA 4245 T2I & Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France.
| | - Jean Dewaele
- Department of Cardiology, CHRU Tours, Tours, France
| | | | - Philippe Gatault
- EA 4245 T2I & Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France.,Department of Nephrology, CHRU de Tours, Tours, France
| | | | | | - Matthias Büchler
- EA 4245 T2I & Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France.,Department of Nephrology, CHRU de Tours, Tours, France
| | | | - Denis Angoulvant
- Department of Cardiology, CHRU Tours, Tours, France.,EA 4245 T2I & Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France
| | - Jean-Michel Halimi
- EA 4245 T2I & Loire Valley Cardiovascular Collaboration, Université de Tours, Tours, France.,Department of Nephrology, CHRU de Tours, Tours, France
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