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Percutaneous recanalization of recent renal artery occlusions: report of 10 cases
1Department of Radiology, University Hospital, Clermont Ferrand, France.
Insights
Percutaneous recanalization successfully restored renal artery flow in most patients, significantly improving kidney function and reducing the need for dialysis in cases of renal artery occlusion.
Area of Science:
- Interventional Nephrology
- Vascular Surgery
- Hypertension Management
Background:
- Renal artery occlusion is a significant cause of hypertension and kidney damage.
- Treatment options for renal artery occlusion are limited, often leading to dialysis.
Purpose of the Study:
- To evaluate the efficacy and safety of percutaneous recanalization for renal artery occlusion.
- To assess the impact of the procedure on blood pressure and renal function.
Main Methods:
- Percutaneous recanalization was performed on 10 patients with renal artery occlusion.
- Patients presented with varying degrees of renal impairment and hypertension.
- Angioplasty and fibrinolysis were used as complementary procedures when necessary.
Main Results:
- Technical success was achieved in most cases, with some early rethrombosis and one complication.
- Blood pressure remained unchanged in some patients but improved in others.
- Significant and durable improvement in serum creatinine levels was observed, enabling dialysis discontinuation in three patients.
Conclusions:
- Percutaneous recanalization is a viable option for treating renal artery occlusion.
- The procedure can prevent end-stage renal disease and the need for dialysis.
- It offers a potential alternative to manage hypertension and preserve kidney function.
Purpose:
Percutaneous recanalization of renal artery occlusion was attempted in 10 patients.
Methods:
All patients were hypertensive; before the procedure, the serum creatinine level was 80 mumol/L in one patient, ranged from 130-250 mumol/L in four patients, and was greater than 350 mumol/L in five, three of whom had anuria. Nine occlusions were thrombotic, one due to bilateral renal artery embolism. In four patients, percutaneous transluminal angioplasty of a contralateral renal artery occlusion was bilateral. In three patients, complementary local fibrinolysis was necessary.
Results:
Three technical failures and one rethrombosis occurred after 24 h; in three of these cases the date of previous occlusion was unknown, whereas a relatively precise data was known for the seven other patients. One false aneurysm of the femoral artery was found 1 month after the procedure. One patient, after six technical successes, died 5 weeks after the procedure; follow-up for the other five was 6-36 months. Blood pressure was unchanged in four patients and improved in two. A significant and durable improvement of creatinine serum level (at least a 20% decrease) was observed in all six patients, usually after 1 month, thus enabling discontinuance of dialysis in three patients.
Conclusion:
Percutaneous recanalization should be proposed in cases of renal artery occlusion, especially to avoid terminal vascular azotemia and dialysis.