Successful Reversal of Acute Kidney Failure by Ultrasound-Accelerated Thrombolysis of an Occluded Renal ArteryReportar como inadecuado




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Case Reports in Medicine - Volume 2014 2014, Article ID 205646, 4 pages -

Case Report

Department of Surgery, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands

Department of Interventional Radiology, VU University Medical Center, Amsterdam, The Netherlands

Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands

Received 30 May 2014; Accepted 27 August 2014; Published 8 September 2014

Academic Editor: W. Zidek

Copyright © 2014 Renske Konings et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To describe the treatment of renal artery thrombosis with ultrasound-accelerated thrombolysis and discuss the management of prolonged renal ischemia. Case. A 76-year-old patient with a single functional kidney, mild chronic renal impairment, and a recent history of endovascular repair of a thoracoabdominal aneurysm with an aortic branch graft presented with acute flank pain, anuria, and renal failure. The side branch from the aortic stent graft to his single, right, functional kidney appeared to be completely thrombosed. Symptoms had started after cessation of oral anticoagulants because of a planned mastectomy for breast cancer. After identification of the occlusion, ultrasound-accelerated thrombolysis was started 19 hours after the onset of anuria. Angiography, 4 hours after beginning of therapy, already showed partial dissolution of the thrombus and angiographic control after 18 hours showed complete patency of the renal artery side branch. Despite a long period of ischemia, renal function was completely recovered. Conclusion. In patients with acute renal ischemia due to thrombosis of the renal artery, complete recovery of function can be achieved with ultrasound-accelerated thrombolysis, even after prolonged periods of ischemia.





Autor: Renske Konings, Rutger J. Lely, Shaikh A. Nurmohamed, and Arjan W. J. Hoksbergen

Fuente: https://www.hindawi.com/



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