Long-Term Outcomes of Endovascular Stenting for Blunt Renal Artery Injuries with Stenosis: A Report of Five Consecutive Cases
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- Okada Ichiro
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center
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- Inoue Junichi
- Emergency and Critical Care Medical Center, Yamanashi Prefectural Central Hospital
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- Kato Hiroshi
- Department of Emergency Medicine, Minamitama Hospital
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- Koido Yuichi
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center
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- Kiriu Nobuaki
- Department of Critical Care Medicine and Trauma, National Hospital Organization Disaster Medical Center
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- Hattori Takayuki
- Department of Radiology, Tokyo Metropolitan Health and Medical Treatment Corporation Ohkubo Hospital
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- Morimoto Kohei
- Department of Radiology, National Hospital Organization Disaster Medical Center
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- Ichinose Yoshiaki
- Department of Radiology, National Hospital Organization Disaster Medical Center
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- Yokota Hiroyuki
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital
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Abstract
<p>Background: Renal artery stenting is performed for renal artery injuries to preserve renal function and prevent renovascular hypertension. However, its indications are controversial and its long-term prognosis remains unknown. Here, we evaluate the characteristics and long-term outcomes of renal artery stenting for blunt renal artery injuries at our institution. Methods: We retrospectively reviewed patients with blunt renal artery injuries who had been treated with stenting over a 12-year period at our institution. Five patients (three men and two women) were included. Results: Trauma resulted from falls in three patients and motor vehicle accidents in two. All patients had experienced multiple injuries (median injury severity score, 24 [range, 16-48]; median revised trauma score, 5.9672 [4.0936-7.8408]; and median probability of survival, 0.689 [0.533-0.980]). All renal artery injuries involved stenosis because of traumatic arterial dissection or intimal tear; no cases of total occlusion were observed. No complications due to the intervention itself were observed. Although two patients developed reversible acute renal failure, none required long-term hemodialysis. One patient with renovascular hypertension was treated with antihypertensive agents for a month and subsequently became normotensive without further medication. All patients underwent postoperative computed tomography, which revealed no stent occlusion or renal atrophy. Renal scintigraphy for three patients demonstrated preserved differential renal function. All five patients survived. Conclusions: Renal artery stenting for hemodynamically stable blunt renal artery injuries with stenosis is suggested to be safe and helps in avoiding long-term hemodialysis and renovascular hypertension.</p>
Journal
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- Journal of Nippon Medical School
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Journal of Nippon Medical School 86 (3), 172-178, 2019-06-26
The Medical Association of Nippon Medical School