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Local thrombolytic treatment for renal arterial embolism
G Glück1, M Croitoru, D Deleanu
1Department of Urology, Fundeni Hospital, Bucharest, Romania. gluckg@iname.com
Insights
Local thrombolysis effectively treated acute renal artery occlusion in a patient with a solitary kidney. This intervention proved successful even after 72 hours, offering a viable treatment option for renal artery blockages.
Area of Science:
- Nephrology
- Interventional Radiology
- Vascular Surgery
Background:
- Acute renal artery occlusion is a critical condition that can lead to kidney damage.
- Early diagnosis and intervention are crucial for preserving renal function.
- Treatment options for renal artery occlusion have evolved, with a focus on revascularization techniques.
Observation:
- A 76-year-old female patient presented with a 72-hour history of anuria and flank pain.
- The patient had a history of left-sided nephrectomy, making the right kidney solitary.
- Diagnostic angiography confirmed acute occlusion of the right renal artery.
Findings:
- Local intra-arterial thrombolysis using streptokinase was administered.
- The thrombolytic therapy successfully restored blood flow to the occluded renal artery.
- The patient experienced a positive outcome, with sustained well-being at a 24-month follow-up.
Implications:
- Local intra-arterial thrombolysis demonstrates significant utility in managing acute renal artery occlusion.
- This approach offers a potential limb-saving and kidney-sparing intervention, even in delayed presentations.
- The findings support considering local thrombolysis as a primary treatment modality for renal artery occlusion.
Objective:
To determine the utility of local thrombolysis in the treatment of acute renal arterial occlusion.
Methods:
We used local thrombolytic treatment in a female patient, aged 76, with 72 h of anuria, right lumbar and flank pain. She had a 3-year history of ischemic heart disease and atrial fibrillation controlled with digital treatment. Also, she was nephrectomized on the left side 33 years ago for lithiasic pyonephrosis. A normal right urinary tract was demonstrated with ultrasound examination, KUB radiography and retrograde pyelography. The next step was diagnostic abdominal angiography and local thrombolytic treatment with streptokinase.
Result:
Thrombolysis with streptokinase was successful following 72 h of renal artery occlusion. After 24 months the patient is doing well.
Conclusion:
Local intra-arterial thrombolysis is the treatment of choice in renal artery occlusion.