Nicholas G G, DeMuth W E
Arch Surg. 1984 Mar;119(3):278-81. doi: 10.1001/archsurg.1984.01390150020005.
Renal artery embolectomy was performed on four patients. There was no operative mortality. Four of the five affected kidneys were salvaged. The most common initial symptom was flank pain. The literature from 1970 to 1982 was reviewed to determine the current operative mortality (11%) and frequency of kidney salvage (67% to 90%) with surgery or anticoagulation. Newer treatment modalities, including intraarterially injected low-dose streptokinase and percutaneous transluminal angioplasty, have also proved useful. The addition of these newer methods, combined with the fact that kidneys can frequently be salvaged after prolonged periods of acute renal artery occlusion, led to the development of a clinical algorithm for treatment. With this algorithm, surgical embolectomy was reserved for patients with total renal parenchymal compromise caused by emboli, whose conditions failed to respond to less invasive treatment modes.
对4例患者实施了肾动脉栓子切除术。无手术死亡病例。5个受累肾脏中的4个得以保留。最常见的初始症状是胁腹痛。回顾了1970年至1982年的文献，以确定目前手术死亡率（11%）以及通过手术或抗凝治疗保留肾脏的频率（67%至90%）。包括动脉内注射低剂量链激酶和经皮腔内血管成形术在内的更新的治疗方式也已证明有效。这些更新方法的加入，再加上长时间急性肾动脉闭塞后肾脏常常能够得以保留这一事实，促成了一种临床治疗算法的形成。根据该算法，手术栓子切除术仅适用于因栓子导致肾实质完全受损且对侵入性较小的治疗方式无反应的患者。
