Endovascular Thrombus Aspiration and Catheter-Directed Thrombolysis for Acute Thromboembolic Renal Artery Occlusion

Abstract

Purpose: We report a case of revascularization for an occluded renal artery using endovascular renal thrombus aspiration followed by catheter-directed thrombolysis. Case Report: A 56-year-old man presented with sudden onset severe left-sided abdominal and loin pain for 6 hours. Urgent computed tomography (CT) angiogram showed occlusion of left renal artery. Emergency selective left renal angiogram and thrombus aspiration using a 5-French Cobra catheter was performed. Catheter-directed thrombolysis with urokinase was initiated after aspiration thrombectomy. Angiogram 24 hours after thrombolysis showed the left renal artery and its segmental branches were successfully revascularized. Patient was put on anticoagulation after operation and his renal function recovered well. Conclusion: Percutaneous aspiration thrombectomy with conventional catheters combined with intra-arterial local fibrinolysis could be used to salvage the renal function in case of complete renal artery thromboembolic occlusion.