Local thrombolytic treatment for renal arterial embolism.

OBJECTIVE

To determine the utility of local thrombolysis in the treatment of acute renal arterial occlusion.

METHODS

We used local thrombolytic treatment in a female patient, aged 76, with 72 h of anuria, right lumbar and flank pain. She had a 3-year history of ischemic heart disease and atrial fibrillation controlled with digital treatment. Also, she was nephrectomized on the left side 33 years ago for lithiasic pyonephrosis. A normal right urinary tract was demonstrated with ultrasound examination, KUB radiography and retrograde pyelography. The next step was diagnostic abdominal angiography and local thrombolytic treatment with streptokinase.

RESULT

Thrombolysis with streptokinase was successful following 72 h of renal artery occlusion. After 24 months the patient is doing well.

CONCLUSION

Local intra-arterial thrombolysis is the treatment of choice in renal artery occlusion.