학술논문
Endovascular Thrombectomy and Lysis for Acute Renal Vein Thrombosis: Indications, Technical Aspects, Outcome, and Disease Etiology.
Document Type
Academic Journal
Author
Low R; Faculty of Medicine, Imperial College London, London, UK.; Crane J; West London Renal and Transplant Center, Hammersmith Hospital, London, UK.; Sackey F; Accident and Emergency Department, Ealing Hospital, London, UK.; Malina M; West London Vascular and Interventional Center, Northwick Park and St Mark's Hospital, London, UK.
Source
Publisher: Sage Publications Country of Publication: United States NLM ID: 100896915 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-1550 (Electronic) Linking ISSN: 15266028 NLM ISO Abbreviation: J Endovasc Ther Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: To report a rare case of acute renal vein thrombosis (RVT) that was treated with endovascular thrombectomy and lysis, and discuss potential etiology and indications for catheter-directed management.
Case Report: A 21-year-old female athlete presented with sudden pain in her left flank and vomiting. A 3-phase computed tomography (CT) angiogram identified total occlusion of the left renal vein with no excretion from the swollen tender left kidney. Catheter-directed thrombolysis and thrombectomy were initiated 24 hours after onset of symptoms. Complete resolution of the RVT with normalized renal function was achieved. Post-operative Doppler ultrasound scan confirmed normal renal resistance and flow in the renal vein. The patient was discharged on Apixaban and remains well at 6 months. Combined hormonal contraception via an intra-vaginal ring and raised Factor VIII activity were the only identified risk factors.
Conclusion: Acute complete RVT with impaired kidney function is rare. Combined hormonal contraception and increased Factor VIII activity were potential risk factors. Endovascular thrombectomy and lysis restored renal perfusion and function, and can be used effectively in the management of fit patients with acutely compromised kidney function from total renal vein obstruction.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Case Report: A 21-year-old female athlete presented with sudden pain in her left flank and vomiting. A 3-phase computed tomography (CT) angiogram identified total occlusion of the left renal vein with no excretion from the swollen tender left kidney. Catheter-directed thrombolysis and thrombectomy were initiated 24 hours after onset of symptoms. Complete resolution of the RVT with normalized renal function was achieved. Post-operative Doppler ultrasound scan confirmed normal renal resistance and flow in the renal vein. The patient was discharged on Apixaban and remains well at 6 months. Combined hormonal contraception via an intra-vaginal ring and raised Factor VIII activity were the only identified risk factors.
Conclusion: Acute complete RVT with impaired kidney function is rare. Combined hormonal contraception and increased Factor VIII activity were potential risk factors. Endovascular thrombectomy and lysis restored renal perfusion and function, and can be used effectively in the management of fit patients with acutely compromised kidney function from total renal vein obstruction.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.