Law Yuk, Chan Yiu Che, Cheng Stephen W
Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong.
Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong.
Ann Vasc Surg. 2016 Oct;36:289.e5-289.e10. doi: 10.1016/j.avsg.2016.02.030. Epub 2016 Jun 25.
Acute arterial thromboembolism to the renal arteries can be treated promptly by local thrombolysis, conventional surgical thrombectomy, or anticoagulation.
We report a patient who presented with acute loin pain as a result of atrial fibrillation-related thromboembolism to the right renal artery supplying his horseshoe kidney. He was already on warfarin treatment with international normalized ratio of 1.7 and had acute bleeding from malignant peptic ulcer disease, so thrombolysis was contraindicated.
He underwent timely endovascular revascularization with aspiration thrombectomy, with good clinical and radiological consequence. He subsequently underwent curative partial gastrectomy and made a steady recovery.
Early endovascular target-directed therapy such as intra-arterial thrombolysis and mechanical aspiration in combination with intravenous heparin therapy will result in renal salvage.
肾动脉急性动脉血栓栓塞可通过局部溶栓、传统外科血栓切除术或抗凝治疗迅速得到处理。
我们报告一名患者，因心房颤动相关血栓栓塞至供应其马蹄肾的右肾动脉而出现急性腰痛。他当时正在接受华法林治疗，国际标准化比值为1.7，且患有恶性消化性溃疡疾病导致急性出血，因此溶栓治疗存在禁忌。
他及时接受了血管内再血管化治疗，采用抽吸血栓切除术，临床和影像学结果良好。他随后接受了根治性部分胃切除术，并稳步康复。
早期血管内靶向治疗，如动脉内溶栓和机械抽吸联合静脉肝素治疗，将有助于挽救肾脏。
Zotero 插件