Traumatic renal artery occlusion treated with an endovascular stent — The limitations of surgical revascularization: Report of a case
When renal artery occlusion occurs secondary to blunt trauma, the recovery rate of renal function after open revascularization is varied and far from satisfactory. Although the optimal treatment for this type of injury has not been established, percutaneous revascularization by endovascular stenting...
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Veröffentlicht in: | Surgery today (Tokyo, Japan) Japan), 2011-07, Vol.41 (7), p.1020-1023 |
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creator | Kushimoto, Shigeki Shiraishi, Shin-Ichiro Miyauchi, Masato Tanabe, Seizan Fukuda, Reo Tsujii, Atsuko Masuno, Tomohiko Kim, Shiei Kawai, Makoto Yokota, Hiroyuki Tajima, Hiroyuki |
description | When renal artery occlusion occurs secondary to blunt trauma, the recovery rate of renal function after open revascularization is varied and far from satisfactory. Although the optimal treatment for this type of injury has not been established, percutaneous revascularization by endovascular stenting has recently been advocated for patients with unilateral renal artery occlusion. We herein report a case of blunt renal artery occlusion treated with an endovascular stent. After the placement of the stent, renal arteriography showed multiple nonflow-limiting contrast defects in the distal renal arteries, suggesting peripheral thrombosis. Although the duration of warm renal ischemia appears to be the crucial determinant of renal function, multiple thrombi in the distal renal arteries, which would be undetectable during open surgery, could also affect the functional outcome. The presence of these thrombi may explain the limited success of surgical revascularization in such cases. |
doi_str_mv | 10.1007/s00595-010-4368-z |
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Although the optimal treatment for this type of injury has not been established, percutaneous revascularization by endovascular stenting has recently been advocated for patients with unilateral renal artery occlusion. We herein report a case of blunt renal artery occlusion treated with an endovascular stent. After the placement of the stent, renal arteriography showed multiple nonflow-limiting contrast defects in the distal renal arteries, suggesting peripheral thrombosis. Although the duration of warm renal ischemia appears to be the crucial determinant of renal function, multiple thrombi in the distal renal arteries, which would be undetectable during open surgery, could also affect the functional outcome. 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Although the optimal treatment for this type of injury has not been established, percutaneous revascularization by endovascular stenting has recently been advocated for patients with unilateral renal artery occlusion. We herein report a case of blunt renal artery occlusion treated with an endovascular stent. After the placement of the stent, renal arteriography showed multiple nonflow-limiting contrast defects in the distal renal arteries, suggesting peripheral thrombosis. Although the duration of warm renal ischemia appears to be the crucial determinant of renal function, multiple thrombi in the distal renal arteries, which would be undetectable during open surgery, could also affect the functional outcome. The presence of these thrombi may explain the limited success of surgical revascularization in such cases.</description><subject>Acute Kidney Injury - therapy</subject><subject>Adult</subject><subject>Case Report</subject><subject>Endovascular Procedures - instrumentation</subject><subject>Endovascular Procedures - methods</subject><subject>Head Injuries, Closed - therapy</subject><subject>Humans</subject><subject>Kidney - blood supply</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Radionuclide Imaging</subject><subject>Renal Artery Obstruction - therapy</subject><subject>Stents</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><issn>0941-1291</issn><issn>1436-2813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLFuFDEURa0IRDaBD6BB7qgm-NnemTEdioAgRUJC21te-23iaGa8-HlA2SodP8AX5kvwZhPKVLb0zj3FYewtiDMQovtAQizNshEgGq3avtkdsQXUXyN7UC_YQhgNDUgDx-yE6EYIqXshXrFjCZ3uW9ku2J9VdvPoSvQ84-QG7nLBfMuT98NMMU28ZHQFA_8dyzV3E8cppF-O_Dy4zKngVPj93V--ukY-xDGW6koT8bThNOer6Ksz49Mg7h7OH_kP3KZc9pTj3hG-Zi83biB88_iestWXz6vzi-by-9dv558uG69MWxpndL922oNHI4PrDEiAfqkBQIcgnVDB6GC8kr1SNUIXaoMA6_XSSKE7dcreH7TbnH7OSMWOkTwOg5swzWT7rpVaaaUqCQfS50SUcWO3OY4u31oQdl_fHurbWt_u69td3bx7tM_rEcP_xVPuCsgDQPU0XWG2N2nONTs9Y_0H-2-TFA</recordid><startdate>20110701</startdate><enddate>20110701</enddate><creator>Kushimoto, Shigeki</creator><creator>Shiraishi, Shin-Ichiro</creator><creator>Miyauchi, Masato</creator><creator>Tanabe, Seizan</creator><creator>Fukuda, Reo</creator><creator>Tsujii, Atsuko</creator><creator>Masuno, Tomohiko</creator><creator>Kim, Shiei</creator><creator>Kawai, Makoto</creator><creator>Yokota, Hiroyuki</creator><creator>Tajima, Hiroyuki</creator><general>Springer Japan</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110701</creationdate><title>Traumatic renal artery occlusion treated with an endovascular stent — The limitations of surgical revascularization: Report of a case</title><author>Kushimoto, Shigeki ; Shiraishi, Shin-Ichiro ; Miyauchi, Masato ; Tanabe, Seizan ; Fukuda, Reo ; Tsujii, Atsuko ; Masuno, Tomohiko ; Kim, Shiei ; Kawai, Makoto ; Yokota, Hiroyuki ; Tajima, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c396t-a948ba4c1ce92da7912118541114dd2a03d94d9c328338137d094d1bb5920473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Acute Kidney Injury - therapy</topic><topic>Adult</topic><topic>Case Report</topic><topic>Endovascular Procedures - instrumentation</topic><topic>Endovascular Procedures - methods</topic><topic>Head Injuries, Closed - therapy</topic><topic>Humans</topic><topic>Kidney - blood supply</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Radionuclide Imaging</topic><topic>Renal Artery Obstruction - therapy</topic><topic>Stents</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kushimoto, Shigeki</creatorcontrib><creatorcontrib>Shiraishi, Shin-Ichiro</creatorcontrib><creatorcontrib>Miyauchi, Masato</creatorcontrib><creatorcontrib>Tanabe, Seizan</creatorcontrib><creatorcontrib>Fukuda, Reo</creatorcontrib><creatorcontrib>Tsujii, Atsuko</creatorcontrib><creatorcontrib>Masuno, Tomohiko</creatorcontrib><creatorcontrib>Kim, Shiei</creatorcontrib><creatorcontrib>Kawai, Makoto</creatorcontrib><creatorcontrib>Yokota, Hiroyuki</creatorcontrib><creatorcontrib>Tajima, Hiroyuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery today (Tokyo, Japan)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kushimoto, Shigeki</au><au>Shiraishi, Shin-Ichiro</au><au>Miyauchi, Masato</au><au>Tanabe, Seizan</au><au>Fukuda, Reo</au><au>Tsujii, Atsuko</au><au>Masuno, Tomohiko</au><au>Kim, Shiei</au><au>Kawai, Makoto</au><au>Yokota, Hiroyuki</au><au>Tajima, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Traumatic renal artery occlusion treated with an endovascular stent — The limitations of surgical revascularization: Report of a case</atitle><jtitle>Surgery today (Tokyo, Japan)</jtitle><stitle>Surg Today</stitle><addtitle>Surg Today</addtitle><date>2011-07-01</date><risdate>2011</risdate><volume>41</volume><issue>7</issue><spage>1020</spage><epage>1023</epage><pages>1020-1023</pages><issn>0941-1291</issn><eissn>1436-2813</eissn><abstract>When renal artery occlusion occurs secondary to blunt trauma, the recovery rate of renal function after open revascularization is varied and far from satisfactory. Although the optimal treatment for this type of injury has not been established, percutaneous revascularization by endovascular stenting has recently been advocated for patients with unilateral renal artery occlusion. We herein report a case of blunt renal artery occlusion treated with an endovascular stent. After the placement of the stent, renal arteriography showed multiple nonflow-limiting contrast defects in the distal renal arteries, suggesting peripheral thrombosis. Although the duration of warm renal ischemia appears to be the crucial determinant of renal function, multiple thrombi in the distal renal arteries, which would be undetectable during open surgery, could also affect the functional outcome. The presence of these thrombi may explain the limited success of surgical revascularization in such cases.</abstract><cop>Japan</cop><pub>Springer Japan</pub><pmid>21748626</pmid><doi>10.1007/s00595-010-4368-z</doi><tpages>4</tpages></addata></record> |
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subjects | Acute Kidney Injury - therapy Adult Case Report Endovascular Procedures - instrumentation Endovascular Procedures - methods Head Injuries, Closed - therapy Humans Kidney - blood supply Male Medicine Medicine & Public Health Radionuclide Imaging Renal Artery Obstruction - therapy Stents Surgery Surgical Oncology |
title | Traumatic renal artery occlusion treated with an endovascular stent — The limitations of surgical revascularization: Report of a case |
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