Blunt renal vascular trauma resulting in arterial avulsion injury with a nephron-sparing outcome.


Journal

Journal of medical imaging and radiation oncology
ISSN: 1754-9485
Titre abrégé: J Med Imaging Radiat Oncol
Pays: Australia
ID NLM: 101469340

Informations de publication

Date de publication:
Dec 2019
Historique:
received: 27 02 2019
accepted: 15 05 2019
pubmed: 8 6 2019
medline: 20 6 2020
entrez: 8 6 2019
Statut: ppublish

Résumé

Blunt renal vascular traumatic injury is uncommon, and most injuries can be managed conservatively in a patient who is clinically stable. Pseudoaneurysm or active bleeding at presentation is rare and in an unstable patient, endovascular techniques offer a low morbidity option for rapid treatment. We present an unusual case of avulsion of a second order renal artery from the main renal artery, with active bleeding at presentation treated by excluding the bleed with a stent graft. This was complicated by delayed pseudoaneurysm formation, treated with a larger stent graft. This resulted in preservation of renal parenchyma and renal function in a young patient.

Identifiants

pubmed: 31173450
doi: 10.1111/1754-9485.12907
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

795-798

Informations de copyright

© 2019 The Royal Australian and New Zealand College of Radiologists.

Références

Shoobridge JJ, Bultitude MF, Koukounaras J et al. A 9-year experience of renal injury at an Australian level 1 trauma centre. BJU Int 2013; 112(S2): 53-60.
Beyer C, Zakaluzny S, Humphries M et al. Multidisciplinary management of blunt renal artery injury with endovascular therapy in the setting of polytrauma: a case report and review of the literature. Ann Vasc Surg 2017; 38: 318.
Hoon Lim K, Kyu Ryeom H, Park J. Endovascular treatment of renal arterial perforation after blunt trauma: case report. Int J of Surgery Case Reports 2018; 42: 208-11.
Sfyroeras GS, Dalainas I, Giannakopoulos TG et al. Flow-diverting stents for the treatment of arterial aneurysms. J Vasc Surg 2012; 56: 839-46.
Kuan JK, Wright JL, Nathens A et al. American Association for the Surgery of Trauma Organ Injury Scale for kidney injuries predicts nephrectomy, dialysis, and death in patients with blunt injury and nephrectomy for penetrating injuries. J Trauma Injury Infection Crit Care 2006; 60: 351-6.
Sofocleous CT, Hinrichs CR, Hubbi B et al. Embolization of isolated lumbar artery injuries in trauma patients Cardiovasc Intervent Radiol 2005; 28: 730.
Stamplf US, Sommer C-M, Bellemann N et al. The use of Balloon-expandable stent grafts for the management of acute arterial bleeding. J Vasc Interv Radiol 2012; 23: 331-7.
Gandini R, Chiaravalloti A, Morosetti D et al. Long-term follow-up of endovascular treatment of renal artery aneurysms with covered stent deployment. European Society of Radiology Annual Meeting. 2015. Poster C-0626. https://doi.org/10.1594/ecr2015/c-0626

Auteurs

Warren Clements (W)

Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.
Department of Surgery, Monash University, Melbourne, Victoria, Australia.

Heather K Moriarty (HK)

Department of Radiology, Alfred Hospital, Melbourne, Victoria, Australia.

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