March 1984

Treatment of Renal Artery Embolism

Author Affiliations

From the Department of Surgery, Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey, Pa. Dr Nicholas is now chief of surgical education, Lehigh Valley Hospital Center and Allentown Hospital, Allentown, Pa.

Arch Surg. 1984;119(3):278-281. doi:10.1001/archsurg.1984.01390150020005

• Renal artery embolectomy was performed on four patients. There was no operative mortality. Four of the five affected kidneys were salvaged. The most common initial symptom was flank pain. The literature from 1970 to 1982 was reviewed to determine the current operative mortality (11%) and frequency of kidney salvage (67% to 90%) with surgery or anticoagulation. Newer treatment modalities, including intra-arterially injected low-dose streptokinase and percutaneous transluminal angioplasty, have also proved useful. The addition of these newer methods, combined with the fact that kidneys can frequently be salvaged after prolonged periods of acute renal artery occlusion, led to the development of a clinical algorithm for treatment. With this algorithm, surgical embolectomy was reserved for patients with total renal parenchymal compromise caused by emboli, whose conditions failed to respond to less invasive treatment modes.

(Arch Surg 1984;119:278-281)