Multidisciplinary Management of Blunt Renal Artery Injury with Endovascular Therapy in the Setting of Polytrauma: A Case Report and Review of the Literature

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• 作者：Carl Beyer¹ ; ^{cbeyer@ucdavis.edu} ; Scott Zakaluzny² ; Misty Humphries³ ; David Shatz²
• 刊名：Annals of Vascular Surgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：38
• 期：Complete
• 页码：318.e11-318.e16
• 全文大小：882 K
• 卷排序：38

文摘

Injury to the renal artery is a rare but serious concern in patients suffering blunt trauma. Complications of renovascular injury include prolonged hospitalization, kidney loss, and death. There remains considerable controversy regarding the optimal treatment of blunt renal artery injury.MethodsWe describe the management of a 39-year-old woman following blunt polytrauma who underwent a multidisciplinary collaborative procedure with open splenectomy and endovascular repair of an occluded renal artery. A literature review of the past 25 years follows including all publications describing endovascular treatment for blunt renal artery injury.ResultsThe literature search identified 27 patients with blunt renal artery injury treated by endovascular means. All patients were treated with angioplasty and stenting; none were treated with angioplasty alone. One patient (4%) required nephrectomy for hypertension and 89% of patients were reported to be in good condition at their last contact with the healthcare system.ConclusionsThe optimal treatment of blunt injury to the renal artery is unknown, but endovascular therapy is a feasible and reasonable choice. Further study is warranted to delineate the appropriate role for endovascular treatment as a component of a multidisciplinary approach to the care of trauma patients with blunt renal artery injury.