title: Multidisciplinary Management of Blunt Renal Artery Injury with Endovascular Therapy in the Setting of Polytrauma: A Case Report and Review of the Literature.
abstract: BACKGROUND
  Injury to the renal artery is a rare but serious concern in patients suffering blunt trauma. Complications of renovascular injury include prolonged hospitalization, kidney loss, and death. There remains considerable controversy regarding the optimal treatment of blunt renal artery injury.
  
  
  METHODS
  We describe the management of a 39-year-old woman following blunt polytrauma who underwent a multidisciplinary collaborative procedure with open splenectomy and endovascular repair of an occluded renal artery. A literature review of the past 25 years follows including all publications describing endovascular treatment for blunt renal artery injury.
  
  
  RESULTS
  The literature search identified 27 patients with blunt renal artery injury treated by endovascular means. All patients were treated with angioplasty and stenting; none were treated with angioplasty alone. One patient (4%) required nephrectomy for hypertension and 89% of patients were reported to be in good condition at their last contact with the healthcare system.
  
  
  CONCLUSIONS
  The optimal treatment of blunt injury to the renal artery is unknown, but endovascular therapy is a feasible and reasonable choice. Further study is warranted to delineate the appropriate role for endovascular treatment as a component of a multidisciplinary approach to the care of trauma patients with blunt renal artery injury.
authors.affiliation: Department of Surgery, University of California Davis Medical Center, Sacramento, CA. Electronic address: cbeyer@ucdavis.edu.
authors.forename: Carl
authors.initials: C
authors.lastname: Beyer
authors.affiliation: Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Department of Surgery, University of California Davis Medical Center, Sacramento, CA.
authors.forename: Scott
authors.initials: S
authors.lastname: Zakaluzny
authors.affiliation: Division of Vascular and Endovascular Surgery, Department of Surgery, University of California Davis Medical Center, Sacramento, CA.
authors.forename: Misty
authors.initials: M
authors.lastname: Humphries
authors.affiliation: Division of Trauma, Acute Care Surgery, and Surgical Critical Care, Department of Surgery, University of California Davis Medical Center, Sacramento, CA.
authors.forename: David
authors.initials: D
authors.lastname: Shatz
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D017130:Angioplasty / Q000295:instrumentation; D003131:Combined Modality Therapy; D000072226:Computed Tomography Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma; D009392:Nephrectomy; D010348:Patient Care Team; D012077:Renal Artery / Q000000981:diagnostic imaging; D013156:Splenectomy; D015607:Stents; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D055815:Young Adult