[Renal artery embolism: thromboaspiration and catheter directed thrombolysis - A successful case]

Renal artery embolism is a rare event and is associated with high risk of hypertension and functional renal loss. We report the clinical case of a renal artery embolism, which was treated using a combination of thromboaspiration and catheter directed thrombolysis, as well a short literature review on this subject. A 60-year-old male with previous medical history of atrial septal defect surgical repair and cardiac pacemaker was presented in the Emergency Department with complains of abdominal pain and vomiting. Patient had suspended oral anticoagulation to undergo a dental surgical procedure. The Angio-CT scan revealed a left renal artery occlusion, suggestive of embolism, with infarction of the ipsilateral kidney. We underwent, 36 hours after the beginning of complains, a left renal artery recanalization with recovery of renal perfusion, using percutaneous thromboaspiration and catheter directed thrombolysis. Renal scintigraphy, at the end of first month, showed left kidney differential function of 38.9%. In the follow-up period (32 months), serum creatinine levels stabilized at 1 mg/dL (1.59 at the admission). Percutaneous interventions, including thromboaspiration and catheter directed thrombolysis, can be used effectively to treat renal artery embolism. Clinical suspicion, lenght of evolution and previous development of a collateral circulation network are key factors to achieve a therapeutic success.