Cardiovascular and interventional radiology · 1994
Percutaneous recanalization of recent renal artery occlusions: report of 10 cases.
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Boyer L, Ravel A, Boissier A, Alexandre M, Cluzel P, Baguet J C, Viallet J F
Аннотация
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.
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.