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RESEARCH PRODUCT

Endovascular Rescue Treatment for Occlusion of Renal Arteries Resulting in Acute Renal Failure

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Urgent revascularization of renal arteries for their occlusions resulting in acute renal failure still remains a therapeutic challenge. In this paper we describe 3 cases of successful endovascular interventions for acute non-iatrogenic occlusions of renal arteries. In the first patient we managed thrombotic occlusion of the renal artery that coexisted with gastrointestinal bleeding. We recanalized occluded renal artery using an extraction catheter and stenting, and managed the bleeding with the use of embolization coils. Endovascular repair resulted in normal dieresis, still several days after the intervention gastrointestinal hemorrhage recurred and patient died due to multiple organ failure. In the second patient there was acute renal failure of the solitary kidney, which resulted from occlusion of the renal artery 4 months after endovascular repair of abdominal aortic aneurysm. We performed thrombectomy of the renal artery and implanted covered stent. In the third patient an acute occlusion of renal artery coexisted with occlusion of distal abdominal aorta. We revascularized the renal artery, superior mesenteric artery and aorta with stentgrafts, using the chimney technique. In the second and third patient the treatment resulted in restored diuresis and normal flow through repaired renal artery at 6-months follow up