Acute thrombosis in a contralateral kidney after radical nephrectomy: successful treatment by thrombolytic therapy using a tissue-type plasminogen activator.
A 67-year-old male became anuric immediately after a right radical nephrectomy for renal cell carcinoma. The patient was diagnosed with an acute arterial thrombosis of the remaining kidney within 4 hours after surgery by both CT scan and angiography. Thrombolytic therapy was started by a transcatheteral infusion of tissue-type plasminogen activator (TPA) resulting in a complete recanalization. Hydration and systemic administration of heparin followed, and renal function recovered within 3 weeks. This is the first report of acute thrombosis in a contralateral renal artery immediately after a radical nephrectomy which was successfully treated with TPA. It is probable that compression of the contralateral renal artery by the retractor for an extended period of time during surgery led to this unfavorable condition.
Tsutsumi
M
M
Department of Urology, Kita-Ibaraki Municipal General Hospital, Japan.
Kasaya
S
S
Sakurai
J
J
Maruyama
T
T
Akaza
H
H
D000368:Aged; D000792:Angiography; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects*; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000188:drug therapy; D012077:Renal Artery; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator