Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: Pooled cohort analysis

Younes Jahangiri, Zachary Ashwell, Khashayar Farsad

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

PURPOSE We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success. Clinical failure was defined as development of new hypertension, serum creatinine rise, or significant asymmetry in split renal function. RESULTS A total of 53 cases have been reported, and 54 cases were analyzed including our case. Median follow-up was 6 months. Technical success was 88.9% and clinical success was 75%. Of 12 treatment failures (25%), 66.7% occurred during the first postprocedure month. Time from injury to revascularization was not a predictor of clinical success (OR=1.00, P = 0.681). Renal artery occlusion was significantly associated with clinical failure (OR=7.50, P = 0.017) and postintervention antiplatelet therapy was significantly associated with treatment success (OR=0.16, P = 0.043). At 37-month follow-up, the stented renal artery in our case remained patent and the patient was normotensive with preserved glomerular filtration rate. CONCLUSION Percutaneous revascularization for blunt renal arterial injury resulted in relatively high technical and clinical success. Time-to-revascularization was independent of successful outcomes. Clinical success was significantly associated with a patent renal artery at the time of intervention and with postprocedure antiplatelet therapy.

Original languageEnglish (US)
Pages (from-to)371-378
Number of pages8
JournalDiagnostic and Interventional Radiology
Volume23
Issue number5
DOIs
StatePublished - Sep 1 2017

Fingerprint

Renal Artery
Cohort Studies
Ischemia
Wounds and Injuries
Kidney
Treatment Failure
Glomerular Filtration Rate
Statistical Factor Analysis
Creatinine
Therapeutics
Hypertension
Serum

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma : Pooled cohort analysis. / Jahangiri, Younes; Ashwell, Zachary; Farsad, Khashayar.

In: Diagnostic and Interventional Radiology, Vol. 23, No. 5, 01.09.2017, p. 371-378.

Research output: Contribution to journalArticle

@article{89a4f86f9afa47f7bcd1ebb77600d7e4,
title = "Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma: Pooled cohort analysis",
abstract = "PURPOSE We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success. Clinical failure was defined as development of new hypertension, serum creatinine rise, or significant asymmetry in split renal function. RESULTS A total of 53 cases have been reported, and 54 cases were analyzed including our case. Median follow-up was 6 months. Technical success was 88.9{\%} and clinical success was 75{\%}. Of 12 treatment failures (25{\%}), 66.7{\%} occurred during the first postprocedure month. Time from injury to revascularization was not a predictor of clinical success (OR=1.00, P = 0.681). Renal artery occlusion was significantly associated with clinical failure (OR=7.50, P = 0.017) and postintervention antiplatelet therapy was significantly associated with treatment success (OR=0.16, P = 0.043). At 37-month follow-up, the stented renal artery in our case remained patent and the patient was normotensive with preserved glomerular filtration rate. CONCLUSION Percutaneous revascularization for blunt renal arterial injury resulted in relatively high technical and clinical success. Time-to-revascularization was independent of successful outcomes. Clinical success was significantly associated with a patent renal artery at the time of intervention and with postprocedure antiplatelet therapy.",
author = "Younes Jahangiri and Zachary Ashwell and Khashayar Farsad",
year = "2017",
month = "9",
day = "1",
doi = "10.5152/dir.2017.16415",
language = "English (US)",
volume = "23",
pages = "371--378",
journal = "Diagnostic and Interventional Radiology",
issn = "1305-3825",
publisher = "Turkish Society of Radiology",
number = "5",

}

TY - JOUR

T1 - Percutaneous renal artery revascularization after prolonged ischemia secondary to blunt trauma

T2 - Pooled cohort analysis

AU - Jahangiri, Younes

AU - Ashwell, Zachary

AU - Farsad, Khashayar

PY - 2017/9/1

Y1 - 2017/9/1

N2 - PURPOSE We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success. Clinical failure was defined as development of new hypertension, serum creatinine rise, or significant asymmetry in split renal function. RESULTS A total of 53 cases have been reported, and 54 cases were analyzed including our case. Median follow-up was 6 months. Technical success was 88.9% and clinical success was 75%. Of 12 treatment failures (25%), 66.7% occurred during the first postprocedure month. Time from injury to revascularization was not a predictor of clinical success (OR=1.00, P = 0.681). Renal artery occlusion was significantly associated with clinical failure (OR=7.50, P = 0.017) and postintervention antiplatelet therapy was significantly associated with treatment success (OR=0.16, P = 0.043). At 37-month follow-up, the stented renal artery in our case remained patent and the patient was normotensive with preserved glomerular filtration rate. CONCLUSION Percutaneous revascularization for blunt renal arterial injury resulted in relatively high technical and clinical success. Time-to-revascularization was independent of successful outcomes. Clinical success was significantly associated with a patent renal artery at the time of intervention and with postprocedure antiplatelet therapy.

AB - PURPOSE We aimed to identify factors related to technical and clinical success of percutaneous revascularization for blunt renal arterial trauma. METHODS All cases of percutaneous revascularization for blunt renal arterial trauma were searched in the available literature. We included a case of iatrogenic renal artery occlusion at our institution treated by percutaneous stenting 20 hours after injury. A pooled cohort analysis of percutaneous revascularization for blunt renal artery injury was then performed to analyze factors related to technical and clinical success. Clinical failure was defined as development of new hypertension, serum creatinine rise, or significant asymmetry in split renal function. RESULTS A total of 53 cases have been reported, and 54 cases were analyzed including our case. Median follow-up was 6 months. Technical success was 88.9% and clinical success was 75%. Of 12 treatment failures (25%), 66.7% occurred during the first postprocedure month. Time from injury to revascularization was not a predictor of clinical success (OR=1.00, P = 0.681). Renal artery occlusion was significantly associated with clinical failure (OR=7.50, P = 0.017) and postintervention antiplatelet therapy was significantly associated with treatment success (OR=0.16, P = 0.043). At 37-month follow-up, the stented renal artery in our case remained patent and the patient was normotensive with preserved glomerular filtration rate. CONCLUSION Percutaneous revascularization for blunt renal arterial injury resulted in relatively high technical and clinical success. Time-to-revascularization was independent of successful outcomes. Clinical success was significantly associated with a patent renal artery at the time of intervention and with postprocedure antiplatelet therapy.

UR - http://www.scopus.com/inward/record.url?scp=85028538523&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028538523&partnerID=8YFLogxK

U2 - 10.5152/dir.2017.16415

DO - 10.5152/dir.2017.16415

M3 - Article

C2 - 28870883

AN - SCOPUS:85028538523

VL - 23

SP - 371

EP - 378

JO - Diagnostic and Interventional Radiology

JF - Diagnostic and Interventional Radiology

SN - 1305-3825

IS - 5

ER -