ISSN 1305-3825 | E-ISSN 1305-3612
Interventional Radiology - Original Article
Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: pooled cohort analysis
1 Department of Interventional Radiology, Charles T. Dotter Institute, Oregon Health and Science University, Portland, Oregon, USA  
Diagn Interv Radiol 2017; 23: 371-378
DOI: 10.5152/dir.2017.16415
Abstract

Purpose: We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma.

 

Methods: All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success. Clinical failure was defined as development of new hypertension, serum creatinine rise, or significant asymmetry in split renal function.

 

Results: A total of 53 cases have been reported, and 54 cases were analyzed including our case.  Median follow-up was 6 months.  Technical success was 88.9% and clinical success was 75%. Of 12 treatment failures (25%), 66.7% occurred during the first postprocedure month. Time from injury to revascularization was not a predictor of clinical success (OR=1.00, P = 0.681). Renal artery occlusion was significantly associated with clinical failure (OR=7.50, P = 0.017) and postintervention antiplatelet therapy was significantly associated with treatment success (OR=0.16, P = 0.043). At 37-month follow-up, the stented renal artery in our case remained patent and the patient was normotensive with preserved glomerular filtration rate. 

 

Conclusion: Percutaneous revascularization for blunt renal arterial injury resulted in relatively high technical and clinical success. Time-to-revascularization was independent of successful outcomes. Clinical success was significantly associated with a patent renal artery at the time of intervention and with postprocedure antiplatelet therapy.

 

You may cite this article as: Jahangiri Y, Ashwell Z, Farsad K. Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: pooled cohort analysis. Diagn Interv Radiol 2017; 23:371–378.

Key Words
Authors
All
Author's Corner
Reviewer's Corner
Survey
Copyright © Turkish Society of Radiology | Latest Update: 01.11.2017