Aspiration thrombectomy of acute atrial fibrillation-related renal artery thromboembolism in a patient with horseshoe kidney

Abstract

AIM: Acute arterial thromboembolism to the renal arteries can be treated promptly by local thrombolysis, conventional surgical thrombectomy, or by anticoagulation. METHODS: We report a patient who presented with acute loin pain as a result of systemic atrial fibrillation related thromboembolism to his right renal artery supplying his horseshoe kidney. He was already on warfarin treatment with INR of 1.7 and had acute bleeding from malignant peptic ulcer disease, so thrombolysis was contraindicated. RESULTS: He underwent timely endovascular revascularization with aspiration thrombectomy, with good clinical and radiological consequences. He subsequently underwent curative partial gastrectomy and made a steady recovery. CONCLUSION: Early endovascular target-directed therapy such as intra-arterial thrombolysis, mechanical aspiration, in combination with intravenous heparin therapy will result in renal salvage.