title: Traumatic occlusion and dissection of the main renal artery: endovascular treatment.
abstract: OBJECTIVE
  To report experience with endovascular treatment of traumatic injuries of the main renal artery.
  
  
  METHODS
  A retrospective review of traumatic injuries to the main renal artery was performed in three major trauma institutions. Eight patients (age range, 17-46 y; mean age, 27 y) presented with main renal artery occlusion (n = 7) or dissection (n = 1) after major blunt abdominal trauma. Associated injuries were present in the majority of patients. The mean time from injury to intervention was 5 hours (range, 2-8 h).
  
  
  RESULTS
  Recanalization of the occluded renal artery with stent placement was successfully achieved in six patients. In two of the eight patients, interventions resulted in extravasation of contrast medium, and embolization of the main renal artery was performed. At follow-up 2-24 months after injury, four patients had kidney atrophy (two treated with embolization and two with stents), two had proven stent patency with functional kidneys, one was normotensive with unknown stent patency, and one was lost to follow-up. One of the patients with an occluded stent developed severe renal hypertension and required nephrectomy.
  
  
  CONCLUSIONS
  The majority of occlusions and dissections of the main renal artery after major blunt abdominal trauma can be successfully treated with recanalization and stent placement. However, long-term kidney salvage is not always achieved, and there is a potential of development of renovascular hypertension, which may require late nephrectomy.
authors.affiliation: Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA. lopera@uthscsa.edu
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Lopera
authors.forename: Rajeev
authors.initials: R
authors.lastname: Suri
authors.forename: Ghazwan
authors.initials: G
authors.lastname: Kroma
authors.forename: Sameer
authors.initials: S
authors.lastname: Gadani
authors.forename: Bart
authors.initials: B
authors.lastname: Dolmatch
mesh_terms: D000007:Abdominal Injuries / Q000209:etiology / Q000628:therapy*; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000784:Aortic Dissection / Q000209:etiology / Q000628:therapy*; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000209:etiology / Q000601:surgery; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D009392:Nephrectomy; D012078:Renal Artery Obstruction / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D015607:Stents; D013781:Texas; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000628:therapy*; D055815:Young Adult