Annals of Vascular Surgery

, Volume 2, Issue 2, pp 161–168 | Cite as

Renal artery emboli: The role of surgical treatment

  • Samuel Bouttier
  • Jean-Pierre Valverde
  • Michel Lacombe
  • Oscar Nussaume
  • Bernard Andreassian
Original Articles


Twelve cases of emboli to the renal artery (one of which was recurrent) were reviewed. In seven patients, emboli were unilateral and the opposite kidney was functional. In five patients, emboli were bilateral or occurred in a solitary kidney, leading to anuria. Cardiac rhythm disorders were encountered in eight patients and were responsible for emboli in other areas in three. Arteriography in ten patients demonstrated seven complete truncal occlusions (one bilateral), two incomplete truncal occlusions, and one distal embolus. One patient with a distal embolus was treated by heparin alone with satisfactory results. One patient in poor general condition was treated with intraarterial streptokinase, resulting in incomplete lysis of the clot. The five patients with anuria were operated on: four regained satisfactory renal function whereas the other patient died. In five patients without anuria who were operated upon, renal function returned to normal in four, and one patient required nephrectomy. Surgical treatment Is imperative with anuria and is indicated in unilateral emboli with a functional contralateral kidney, especially when there is complete occlusion of the renal trunk. If the embolus is recent, intraarterial fibrinolytic treatment or percutaneous embolectomy can be attempted, but these techniques are not of proven efficacy. Patients with distal emboli or contraindications to operation should be treated by anticoagulant therapy, alone or with local fibrinolytic treatment

Key Words

renal artery emboli renal arterial 


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  1. 1.
    HOXIE HJ, COGGIN CB. Renal infarction. Statistical study of two hundred and five cases and detailed report of an unusual case.Arch Intern Med 1940;65:587–594.Google Scholar
  2. 2.
    PETERSON NE, McDONALD DF. Renal embolization.J Urol 1968;700:140–145.Google Scholar
  3. 3.
    SCHOENBAUM S, GOLDMAN MA, SIEGELMAN SS. Renal arterial embolization.Angiology 1971;22:332–343.CrossRefPubMedGoogle Scholar
  4. 4.
    LACOMBE M. The surgical treatment of renal embolism with anuria.Surg Gynecol Obstet 1971;133; 419–424.PubMedGoogle Scholar
  5. 5.
    LACOMBE M. Les embolies de l’artère rénale.Rev Médecine 1977;78:963–968.Google Scholar
  6. 6.
    CRONAN JJ, DORFMAN GS. Low dose thrombolysis: a non operative approach to renal artery occlusion.J Urol 1983;750:757–759.Google Scholar
  7. 7.
    MCGONIGLE RJS, TRAFFORD JAP, SHARPSTONE P, TAPSON JS. Survival after bilateral renal artery occlusion.Br Med J 1979;1261–1262.Google Scholar
  8. 8.
    MIGNON F, JOSSO F, AMIEL C, et al. Tentative de traitement d’une obstruction vasculaire rénale par la streptokinase chez deux anuriques.Ann Med Int 1969;720:661–668.Google Scholar
  9. 9.
    NICHOLAS GG, DEMUTH WE. Treatment of renal artery embolism.Arch Surg 1984;779:278–281.Google Scholar
  10. 10.
    PATEL HD, HARRIS J. Isolated metachronous renal artery em-boli.Surgery 1976;79:37–41.PubMedGoogle Scholar
  11. 11.
    LACOMBE M. Surgical versus medical treatment of renal artery embolism.J Cardiovasc Surg 1977;78:281–290.Google Scholar
  12. 12.
    LACOMBE M. Les obstructions aiguës non traumatiques de l’artère rénale.Presse Méd 1984;75:2425–2428.Google Scholar
  13. 13.
    HAKAMI M, MOSAVY SH, SAGHAFI MR. Renal artery embolectomy.Angiology 1976;27:255–257.CrossRefPubMedGoogle Scholar
  14. 14.
    TOUBOL J, RAYMOND G, AMIEL J, PASTORINI P. Embolie cruorique de l’artère rénale.J Urol (Paris) 1980;86:211–214.Google Scholar
  15. 15.
    FLYE MW, ANDERSON RW, FISH JC, SILVER D. Successful surgical treatment of anuria caused by renal artery occlusion.Ann Surg 1982;795:346–353.CrossRefGoogle Scholar
  16. 16.
    MOYER JD, RAO CN, WIDRICH WC, OLSSON CA. Conservative management of renal artery embolus.J Urol 1973;709:138–143.Google Scholar
  17. 17.
    LESSMAN RK, JOHNSON SF, COBURN JW, KAUFMAN JJ. Renal artery embolism: clinical features and long-term follow-up of 17 cases.Ann Intern Med 1978;89:477–482.PubMedGoogle Scholar
  18. 18.
    PLAINFOSSE MC, KATZ M, LAVAL-JEANTET M, et al. Diagnostic radiologique de l’embolie de l’artère rénale.Ann Radiol 1976;79:505–512.Google Scholar
  19. 19.
    CHEHVAL MJ, MEHAN DJ. Non operative management of renalartery embolus.Urology 1979;74:569–572.CrossRefGoogle Scholar
  20. 20.
    GAGNON RF, STRAATON K, HERBA MJ, KAYE M. Resolution of massive renal artery thromboembolism with conservative therapy.Canad Med Assoc J 1981;725:1341–1343Google Scholar
  21. 21.
    FERGUS JN, JONES NF, THOMAS ML. Kidney function after renal arterial embolism.Brit Med J 1969;4:587.CrossRefPubMedGoogle Scholar
  22. 22.
    BOTTGER E, REGULA H, BURGHARD A. Angiographische befunde vor und nach streptokinasebehandlung bei nierenarteri-enembolie.Fortschr Geb Roentgenstr Nuktear Med 1971;775:742.CrossRefGoogle Scholar
  23. 23.
    MONTES XLT, JIMENEZ MAA, AGUIAR L, et al. Renal artery thrombosis occurring in an adult with the idiopathic nephrotic syndrome: results of local treatment with streptokinase.Clin Nephrology 1979;72:90–92.Google Scholar
  24. 24.
    KATZEN BT, VANBREDÀ A. Low dose streptokinase in the treatment of arterial occlusions.Am J Radiol 1981;756:1171–1178Google Scholar
  25. 25.
    FISCHER CP, KONNAK JW, CHO KJ, et al. Renal artery embolism: therapy with intra-arterial Streptokinase infusion.J Urol 1981;725:402–404.Google Scholar
  26. 26.
    RUDY DC, SEIGEL RS, PARKER TW, WOODSIDE JR. Segmental renal artery emboli treated with low dose intraarterial streptokinase.Urology 1982;79.410–413.CrossRefGoogle Scholar
  27. 27.
    GAGNON RF, HOROSKO F, HERBA MJ. Local infusion of low-dose streptokinase for renal artery thromboembolism.Can Med Assoc J 1984;757:1089–1091.Google Scholar
  28. 28.
    WOOD WA, TISNADO J, CHO SR. Visceral embolization during low-dose fibrinolysis of aortic graft occlusion.Am J Radiol 1983;747:1055–1056.Google Scholar
  29. 29.
    TESTARD J, HUMBERT G, TENIERE P, LEROY J. Anurie par embolie artérielle renale: traitement par l’urokinase.Ann Med Reims 1975;12, no spécial: 123–124.Google Scholar
  30. 30.
    MILLAN VG, SHER MH, DETERLING RA, et al. Transcatheter thromboembolectomy of acute renal artery occlusion.Arch Surg 1978;775:1086–1092.Google Scholar
  31. 31.
    MAXWELL DD, MISPIRETA LA. Transfemoral renal artery embolectomy.Radiology 1982;745:653–654.Google Scholar
  32. 32.
    BUXTON DR, MUELLER CF. Removal of iatrogenic clot by transcatheter embolectomy.Radiology 1974;777:39–41.Google Scholar
  33. 33.
    THELEN M, WEISSBACH L, BOLDT I. Transfemoral thrombusaspiration aus einer nierenarterie mit angiographiekathetem.Fortschr Rontgenstr 1979;750:594–596.CrossRefGoogle Scholar
  34. 34.
    NEIMANN JL, GODENIR JP, ROCHE G, VOIRIOT P. Végétations mitrales obstructives au cours d’une endocardite bactérienne.Arch Mal Coeur 1980;75:1217–1222.Google Scholar
  35. 35.
    35. GILL TJ, DAMMIN GJ. Paradoxical embolism with renal failure caused by occlusion of the renal arteries.Am J Med 1958;25:780–787.CrossRefPubMedGoogle Scholar
  36. 36.
    MUNDTH ED, SHINE K, AUSTEN WG. Correction of malignant hypertension and return of renal function following late renal artery embolectomy.Am J Med 1969;46:985–988.CrossRefPubMedGoogle Scholar
  37. 37.
    HALPERN M. Acute renal artery embolus: a concept of diagnosis and treatment.J Urol 1967;98:552–561.PubMedGoogle Scholar
  38. 38.
    MCCONNEL RW, FORE WW, TAYLOR A. Embolic occlusion of the renal artery following arteriography.Radiology 1973;707:273–274.Google Scholar
  39. 39.
    FOLEY WJ, KRAFT RO, ARBOR A. Renal artery embolectomy.Arch Surg 1971;705:748–751.Google Scholar
  40. 40.
    GOLDMAN M, THOUA Y, DHAENE M, TOUSSAINT C. Necrotizing glomerulonephritis associated with cholesterol microemboli.Br Med J 1985;290:205–206.CrossRefGoogle Scholar
  41. 41.
    JONES DB, IANNACCONE PM. Atheromatous emboli in renal biopsies.Am J Path 1975;78:261–270.PubMedGoogle Scholar
  42. 42.
    MORRIS GC, HEIDER CF, MOYER JH. The protective effect of subfiltration arterial pressure on the kidney.Surg Forum 1956;6:623–627.PubMedGoogle Scholar
  43. 43.
    PERKINS RP, JACOBSEN DS, FEDER FP, et al. Return of renal function after late embolectomy.N Engl J Med 1967;276:1194–1195.PubMedGoogle Scholar
  44. 44.
    SANFELIPPO CJ, GOLDIN A. Intra-arterial streptokinase and renal artery embolization.Urology 1978;77:62–68.CrossRefGoogle Scholar
  45. 45.
    OURIEL K, ANDRUS CH, RICOTTA JJ, et al. Acute renal artery occlusion: when is revascularization justified?J Vase Surg 1987;5:348–355.CrossRefGoogle Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1988

Authors and Affiliations

  • Samuel Bouttier
    • 1
  • Jean-Pierre Valverde
    • 1
  • Michel Lacombe
    • 1
  • Oscar Nussaume
    • 1
  • Bernard Andreassian
    • 1
  1. 1.Department of Vascular and Thoracic SurgeryHôpital BeaujonClichyFrance

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