Renal artery occlusion (acute)

Renal artery occlusion can happen acutely due to in-situ thrombus, embolism, or dissection. Unless immediately treated, it can lead to renal infarction 1.

The condition is more common in the elderly, however, it may be seen in a younger age group if they have risk factors (described below). 10% of the cases have bilateral involvement.

Acute pain in the ipsilateral flank, lower abdomen or back are the usual presenting symptoms.

Risk factors
Fluoroscopy - IVP
  • after contrast administration there may be faint opacification (or nonopacification) of the affected kidney (with 'rim nephrogram' sign)
  • the affected kidney may be normal or enlarged
CT
  • acutely swollen and oedematous kidney with perinephric stranding 2
  • patchy enhancement or non-enhancing kidney +/- 'cortical rim sign'
  • wedge-shaped focal infarcts if a segmental artery occlusion
Angiography (CT and conventional)

CT angiography shows the hypodense thrombus within the lumen, with possible attenuation of distal branches.

Acute renal artery occlusion is an emergency and requires immediate intervention. Treatment modalities include anticoagulation and thrombolysis/thrombectomy with renal artery stenting 1,3.

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Article information

rID: 16214
Synonyms or Alternate Spellings:
  • Renal artery thrombosis
  • Acute renal artery occlusion

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