PMID: 15373170Sep 18, 2004Paper

Traumatic dissection of the renal pedicle. Modalities of management in adults and children

Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie
Jean-Alexandre LongJean-Jacques Rambeaud

Abstract

To evaluate the medium-term results of treatment for traumatic dissection of the renal arteries in a series of 12 cases and to propose emergency management based on recent endovascular revascularization techniques. Between January 1999 and July 2003, 12 patients were admitted for closed trauma of the renal artery. There were 11 dissections with thrombosis and 1 intimal flap without distal thrombosis. Six patients were revascularized surgically (3 reno-renal bypass grafts, 3 auto-transplantations), 4 patients were treated by an endovascular procedure and 2 patients were treated conservatively with simple surveillance. Renal function, renal artery patency and blood pressure were evaluated immediately and at 3 months by clinical examination, Doppler ultrasound of the renal artery or CT angiography, and renal scintigraphy. In the group of 6 patients undergoing surgical revascularization (mean warm ischaemia time: 8 hours 30 minutes), 2 nephrectomies were performed (1 failure of revascularization, 1 sepsis in a non-functioning kidney). The other 4 patients presented negligible renal function on scintigraphy at 3 months despite patent renal arteries. Among the 4 patients undergoing endovascular revascularization (mean warm ischaemia ...Continue Reading

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