Revascularization of a single-kidney occluded stent for renal salvage complicated by guide wire distal artery perforation and reperfusion injury
| Autor: | Lazaros Reppas, Stavros Spiliopoulos, Konstantinos Palialexis, Elias Brountzos, Angeliki Pastroma |
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| Rok vydání: | 2020 |
| Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty lcsh:R895-920 medicine.medical_treatment Perforation (oil well) Renal function Revascularization 030218 nuclear medicine & medical imaging 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Angioplasty medicine Endovascular treatment Radiology Nuclear Medicine and imaging Creatinine Renal ischemia business.industry Stent Trans-catheter arterial thrombolysis Flash pulmonary edema medicine.disease Surgery chemistry 030220 oncology & carcinogenesis Balloon angioplasty Acute renal ischemia business |
| Zdroj: | The Egyptian Journal of Radiology and Nuclear Medicine, Vol 51, Iss 1, Pp 1-5 (2020) |
| ISSN: | 2090-4762 |
| Popis: | Background The complexity of the case, including the rarefied simultaneous occurrence of complications—iatrogenic, as well as reperfusion injury, invite reporting and publication. Case presentation A 39-year-old woman with a single-functioning left kidney, previous left renal artery stenting (RAS), and known hypercoagulopathy was hospitalized for flash pulmonary edema, elevated serum creatinine (9.7 mg/dl), and refractory hypertension. She was subsequently referred to our center [2] for endovascular treatment of acute renal ischemia (AKI) due to RAS occlusion. Periprocedural complications of guide-wire arterial perforation and reperfusion injury resulted in life-threatening hemorrhage. Conclusions Following more than 48 h of hypoperfusion of the left kidney, revascularization of the thrombosed RAS was successfully attempted with selective, trans-catheter thrombolysis, and balloon angioplasty. Ultra-selective, nephron-sparing coil embolization was successfully performed. The patient’s creatinine level decreased to 2.8 mg/dl at 12 days and to 1.5 mg/dl at 3 months. After 1 year of follow-up, the stent remains patent, and the patient is asymptomatic with stable renal function. |
| Databáze: | OpenAIRE |
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