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Renal Artery Thrombosis

Thrombosis of Renal Artery


Presentation

  • We present a case of acute renal artery thrombosis due to disseminated zygomycosis in a healthy young adult male.The diagnosis of renal artery occlusion was made on contrast-enhanced CT (CECT) and confirmation of etiology was made only on post mortem[ncbi.nlm.nih.gov]
  • The only presenting symptom was left flank pain and no predisposing factors could be found on clinical or laboratory examination.[ncbi.nlm.nih.gov]
  • Renal artery thrombosis after blunt trauma presented without other injury, without external signs of trauma, and without hematuria in the case reported.[ncbi.nlm.nih.gov]
  • PURPOSE: We present our experience with percutaneous rheolytic treatment with the AngioJet thrombectomy catheter for acute renal-artery thrombosis.[ncbi.nlm.nih.gov]
  • We present a case of acute renal artery thrombosis after a living-related kidney transplant with successful treatment with operative thrombectomy and intraarterial infusion of recombinant tissue-type plasminogen activator.[ncbi.nlm.nih.gov]
Easy Bruising
  • A previously healthy 20-year-old male with a history of easy bruising presented to the emergency department complaining of intermittent left lower quadrant abdominal pain for one week.[ncbi.nlm.nih.gov]
Coronary Artery Disease
  • Risk factors include: Older age Being female Having hypertension Having other vascular disease (such as coronary artery disease and peripheral artery disease ) Having chronic kidney disease Having diabetes Using tobacco Having an abnormal cholesterol[webmd.com]
  • He has a history of coronary artery disease, diabetes, hypertension, and atrial fibrillation, but no prior kidney stones. His initial vital signs show HR 82, BP 155/92, RR 22, Sat 98% on room air, and temperature 98F.[emdocs.net]
Fishing
  • Flye MW, Anderson RW, Fish JC, Silver D (1982) Successful surgical treatment of anuria caused by renal artery occlusion. Ann Surg 195: 346–353 Google Scholar 2.[link.springer.com]
Left Lower Quadrant Pain
  • A young female presented with acute left lower quadrant pain followed by nausea and vomiting. She was found to have haematuria and elevated serum creatine.[ncbi.nlm.nih.gov]
  • Oral contraceptive causing renal artery thrombosis Summary A young female presented with acute left lower quadrant pain followed by nausea and vomiting. She was found to have haematuria and elevated serum creatine.[casereports.bmj.com]
Epigastric Pain
  • Review of 65 cases from the literature showed that flank and epigastric pain and proteinuria are usually present. Renal artery thrombosis following blunt trauma has usually been diagnosed too late to salvage the kidney.[ncbi.nlm.nih.gov]
Left Flank Pain
  • The only presenting symptom was left flank pain and no predisposing factors could be found on clinical or laboratory examination.[ncbi.nlm.nih.gov]
Hypertension
  • […] for hypertension to develop after sudden renal-artery occlusion in man.[ncbi.nlm.nih.gov]
  • Conservative treatment was initially planned in consideration of the delayed diagnosis ( 3 hours), but the patient subsequently developed hypertension not controllable with anti-hypertensive drugs.[ncbi.nlm.nih.gov]
  • Abstract Renal arterial thrombosis from blunt trauma causes delayed hypertension in many patients, but few reports have been well documented.[ncbi.nlm.nih.gov]
  • Resolution of systemic hypertension and partial return of right renal function followed rapid thrombus dissolution.[ncbi.nlm.nih.gov]
  • Nephrectomy is performed for ileus, fever, and pain caused by the necrotic kidney, or for hypertension.[ncbi.nlm.nih.gov]
Vascular Disease
  • Patients with underlying vascular disease may be risking cardiovascular complications from recreational or medical use of cocaine.[ncbi.nlm.nih.gov]
  • You are more likely to have vascular disease as you get older.[icdlist.com]
  • Risk factors include: Older age Being female Having hypertension Having other vascular disease (such as coronary artery disease and peripheral artery disease ) Having chronic kidney disease Having diabetes Using tobacco Having an abnormal cholesterol[webmd.com]
  • Both ideally are used in conjuction with each other, however, in circumstances where the renal artery is not seen in its entirety then the indirect approach alone can give an indication of vascular disease.[ultrasoundpaedia.com]
Excoriation
  • She complained about abdominal pain localised in the strip with excoriations and haematomas passing through the abdomen obliquely from the left side up to the right side (in accordance with the course of the seat belt).[omicsonline.org]
Neglect
  • However, small infarcts, which need other imaging modalities for further evaluation and confirmation, may be neglected by CDS.[ncbi.nlm.nih.gov]
Stupor
  • Moreover, he developed stupor due to central nervous system (CNS) lupus a week after the occurrence of the hypertensive episode.[ncbi.nlm.nih.gov]
Generalized Seizure
  • A 13-year-old Japanese boy with an 11-month history of systemic lupus erythematosus (SLE) without antiphospholipid antibodies (APAs) suddenly developed severe hypertension, associated with fever and generalized seizures, and mild abdominal pain.[ncbi.nlm.nih.gov]
Altered Mental Status
  • This case represents spontaneous renal artery thrombosis associated with an altered mental status. Clinical features with suspected etiologies are reviewed. Recommendations for future evaluations are given.[ncbi.nlm.nih.gov]
Flank Pain
  • The only presenting symptom was left flank pain and no predisposing factors could be found on clinical or laboratory examination.[ncbi.nlm.nih.gov]
  • The clinical hallmarks include epigastric or flank pain and proteinuria, or hematuria following blunt trauma to the back or abdomen. Traditional practice suggests that revascularization should not be attempted more than 20 hours after injury.[ncbi.nlm.nih.gov]
  • CASE REPORT: A 63-year-old male patient with renal-artery thrombosis presented 48 hours after the onset of acute nonradiating flank pain. Thrombosis was documented by CT angiography, 99mTc-DTPA, and digital subtraction angiography.[ncbi.nlm.nih.gov]
  • Case Presentation The patient is a 58-year-old previously healthy female that presented to the emergency department for acute onset of left-sided flank pain.[austinpublishinggroup.com]
  • He complained of flank pain, and subsequent simple x-ray and pelvis computed tomography revealed a right acetabular fracture, which we decided to treat conservatively. There were no other major injuries.[circ.ahajournals.org]

Workup

  • Though easily treatable, this is a condition which is seldom investigated in the workup of thrombotic disorders.[ncbi.nlm.nih.gov]
  • Topics include: Non-neoplastic diseases in kidney cancer; Nephrectomy for non-neoplastic causes; Autopsy renal pathology; Practical approach to kidney donation workup; Kidney allograft pathology; Renal infections; Amyloidosis - all subtypes; Histologic[books.google.com]
  • Initial laboratory workup revealed a leukocytosis of 12.9 bil/L. Basic metabolic panel, including creatinine, was unremarkable and urinalysis was normal. Lactate dehydrogenase (LDH) was slightly elevated at 258 U/L.[austinpublishinggroup.com]
Erythrocytosis
  • He developed erythrocytosis (Hb 17.6 g/dl) following a cadaveric renal transplantation. No signs suggesting polycythemia vera were found. Nonrenal causes of secondary erythrocytosis such as anoxia, hemoglobinopathies or tumors were excluded.[ncbi.nlm.nih.gov]
  • Erythrocytosis associated with renal artery thrombosis in a patient with polycystic kidney disease on hemodialysis. Acta Haematol 1990;84:40-2. 3. Dimitroulis D, Bokos J, Zavos G, Nikiteas N, Karidis NP, Katsaronis P, et al.[najms.org]

Treatment

  • Renal arterial thrombosis because of blunt abdominal trauma is still an underreported entity, treatment for which has not yet been established. Both early nephrectomy and delayed revascularization are not justified treatment options.[ncbi.nlm.nih.gov]
  • Conservative treatment was initially planned in consideration of the delayed diagnosis ( 3 hours), but the patient subsequently developed hypertension not controllable with anti-hypertensive drugs.[ncbi.nlm.nih.gov]
  • Treatment of compressive pathologies with stenting can lead to stent failure. Surgery remains the best approach for the treatment of this type of lesion.[ncbi.nlm.nih.gov]
  • PURPOSE: We present our experience with percutaneous rheolytic treatment with the AngioJet thrombectomy catheter for acute renal-artery thrombosis.[ncbi.nlm.nih.gov]
  • We present a case of acute renal artery thrombosis after a living-related kidney transplant with successful treatment with operative thrombectomy and intraarterial infusion of recombinant tissue-type plasminogen activator.[ncbi.nlm.nih.gov]

Prognosis

  • However, the prognosis at present still remains poor.[ncbi.nlm.nih.gov]
  • Treatment and prognosis Acute renal artery occlusion is an emergency and requires immediate intervention. Treatment modalities include anticoagulation and thrombolysis/thrombectomy with renal artery stenting 1,3 . Promoted articles (advertising)[radiopaedia.org]
  • Outlook (Prognosis) Damage caused by arterial occlusion may go away. However, in most cases, it is permanent. If only one kidney is affected, the healthy kidney may take over filtering the blood and producing urine.[m.ufhealth.org]

Etiology

  • We present a case of acute renal artery thrombosis due to disseminated zygomycosis in a healthy young adult male.The diagnosis of renal artery occlusion was made on contrast-enhanced CT (CECT) and confirmation of etiology was made only on post mortem[ncbi.nlm.nih.gov]
  • Clinical features with suspected etiologies are reviewed. Recommendations for future evaluations are given.[ncbi.nlm.nih.gov]
  • This article illustrates the danger of generalizing endovascular stenting in renal artery disease regardless of the etiology. Renal artery entrapment must be kept in mind as a possible cause of renal artery stenosis.[ncbi.nlm.nih.gov]
  • Liu discussed an article by Oh that found that the most common etiology was cardiogenic, followed by idiopathic, renal artery injury, and hypercoagulable state. Labs include an elevated LDH, hematuria, and occasionally leukocytosis.[imrespdx.com]
  • The etiologies of end stage renal disease reported in our study were: one case of nephronophtisis, one case of renal hypoplasia and one case of vesico-ureteral reflux. The etiology was unknown in one case.[latunisiemedicale.com]

Epidemiology

  • In vitro data suggest that drugs such as cyclosporine and OKT3 increase the risk of thrombosis, but it has not been borne out in clinical practice. [8] Epidemiological data suggest increased risk of thrombosis in patients undergoing second transplant[ijtonline.in]
  • View Article Google Scholar Bökenkamp A, von Kries R, Nowak-Göttl U, Göbel U, Hoyer PF: Neonatal renal venous thrombosis in Germany between 1992 and 1994: epidemiology, treatment and outcome. Eur J Pediatr. 2000, 159: 44-48. 10.1007/s004310050008.[ijponline.biomedcentral.com]
  • Liaño F, Pascual J: Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int 1996;50:811-818.[karger.com]
Sex distribution
Age distribution

Prevention

  • Abstract Epsilon aminocaproic acid (EACA) has been used to prevent rebleeding in patients with subarachnoid hemorrhage (SAH).[ncbi.nlm.nih.gov]
  • Collateral flow prevented kidney necrosis.[ncbi.nlm.nih.gov]
  • After the procedure, urokinase was given to prevent distal occlusions from emboli that could have escaped mechanical thrombectomy. Heparin was also administered.[ncbi.nlm.nih.gov]
  • Doherty Lippincott Williams & Wilkins, 2006 - 826 من الصفحات This volume offers authoritative, evidence-based recommendations for preventing and managing complications in all current general surgery procedures.[books.google.com]
  • How to use an article about therapy or prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA 1994;271:59-63. 79.[books.google.com]

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