Haas C A, Dinchman K H, Nasrallah P F, Spirnak J P
Department of Urology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, Ohio 44109-1998, USA.
J Trauma. 1998 Sep;45(3):557-61. doi: 10.1097/00005373-199809000-00024.
To better define what constitutes appropriate treatment for traumatic renal artery occlusion, we report our 15-year experience in managing this injury.
A retrospective chart review was performed to evaluate treatment outcomes and complications of 12 patients (13 injuries) who presented to our trauma centers with renal artery occlusion secondary to blunt injury.
Five of 12 patients underwent attempted surgical revascularization with a median warm ischemia time of 5 hours (range, 4.5-36 hours). Of these five patients, one required nephrectomy for inability to establish arterial flow, three demonstrated no function, and one had return to 9% differential function on postoperative renal scan. Seven patients did not have attempted revascularization, and none of them experienced immediate complications. Hypertension developed in three patients (43%) who required nephrectomy to control blood pressure at a mean of 5 months after injury (range, 3-7 months). Four patients remained asymptomatic and normotensive at a mean follow-up of 11 months (range, 4 weeks to 2.6 years).
Surgical revascularization for traumatic renal artery occlusion seldom results in a successful outcome. Patients who are observed must have close follow-up for hypertension.
