scholarly journals Successful Salvage of a Renal Allograft after Acute Renal Vein Thrombosis due to May-Thurner Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Omkar U. Vaidya ◽  
Todd Buersmeyer ◽  
Rebecca Rojas ◽  
Bart Dolmatch
Keyword(s):  
Renal Vein ◽  
Kidney Injury ◽  
Deceased Donor ◽  
Iliac Vein ◽  
Renal Vein Thrombosis ◽  
Renal Ultrasound ◽  
Vein Thrombosis ◽  
History Of ◽  
Clot Burden ◽  
Deceased Donor Kidney Transplant

A 68-year-old Caucasian female with a past medical history of a deceased donor kidney transplant four months prior was admitted with a two-day history of anuria and acute kidney injury. A renal ultrasound demonstrated thrombus in the transplanted kidney's renal vein that extended into the left iliac vein as well as into the left femoral venous system. Catheter-guided tissue thrombolytics were infused directly into the clot. Within twelve hours of initiating thrombolytic infusion, there was brisk urine output. Interval venography demonstrated decreasing clot burden. At the time of discharge her creatinine was 0.78 mg/dL, similar to her baseline value prior to presentation. The patient was noted to have May-Thurner syndrome on intravascular ultrasound (IVUS). Angioplasty followed by stent placement was done. Unique to our case report was the timing of the presentation of renal vein thrombosis (four months after transplant) and the predisposing anatomy consistent with May-Thurner syndrome, which was diagnosed with IVUS and successfully treated with local thrombolytics.

Endovascular Treatment of an Extensive Iliocaval and Renal Vein Thrombosis Secondary to Inferior Vena Cava Stenosis and May-Thurner Type Iliac Vein Compression: A Case Report

2020 ◽  
Vol 54 (3) ◽  
pp. 297-300 ◽  
Author(s):  
Thomas Frederick Barge ◽  
Emma Wilton ◽  
Andrew Wigham
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Iliac Vein ◽  
Renal Vein Thrombosis ◽  
Endovascular Techniques ◽  
Vein Thrombosis ◽  
Iliac Vein Compression

A 23-year-old presenting with an acute history of back pain, leg swelling, and claudication was diagnosed with an extensive iliocaval thrombosis, extending from the popliteal veins into the inferior vena cava (IVC) and left renal vein. He was treated with a combination of endovascular techniques, including EKOS and AngioJet. An underlying congenital IVC stenosis and May-Thurner type iliac vein compression were subsequently treated with venoplasty and stenting. To our knowledge, this is the first report of the use of EKOS for renal vein thrombosis and we highlight the complementary nature of different endovascular techniques for managing complex venous thrombotic disease.

scholarly journals Non Catether Induced Renal and Inferior Vena Cava Trombosis in a Neonate: A Case Report

2018 ◽  
Vol 6 (9) ◽  
pp. 1678-1681 ◽  
Author(s):  
Natasha Aluloska ◽  
Snezana Janchevska ◽  
Velibor Tasic
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Abdominal Mass ◽  
Vena Cava ◽  
Renal Vein Thrombosis ◽  
Renal Ultrasound ◽  
Gross Hematuria ◽  
Vein Thrombosis ◽  
Vena Cava Thrombosis

BACKGROUND: Neonatal renal vein thrombosis is the most common vascular condition in the newborn kidney, which could lead to serious complication in infants.CASE REPORT: We report a case of the unilateral renal vein and inferior vena cava thrombosis, presented with gross hematuria and thrombocytopenia in a neonate. The neonate was a macrosomic male born to a mother with hyperglycemia in pregnancy. The baby was born with perinatal asphyxia and early neonatal infection and massive hematuria. Clinical and laboratory examination showed enlarged kidney having corticomedullary differentiation diminished and azotemia. Diagnosis of renal vein thrombosis was suspected by renal ultrasound and confirmed by magnetic urography. Prothrombotic risk factors were evaluated. The child is being managed conservatively. Measures aimed at the prevention of end-stage renal disease because of its poor outcome were highlighted. Despite anticoagulant therapy, the right kidney developed areas of scarring and then atrophy.           CONCLUSION: In this work, we present a patient with multiple entities in the aetiology of non-catheter induced renal and vena cava thrombosis in a neonate. Clinicians should suspect renal vein thrombosis in neonates when presented with early postnatal gross hematuria, palpable abdominal mass and thrombopenia.

Acute kidney injury as the first sign of spontaneous renal vein thrombosis: report of 2 cases

2011 ◽  
Vol 33 (1) ◽  
pp. 129-132 ◽  
Author(s):  
Shi Shumei ◽  
Xu Ling ◽  
Wang Yanxia ◽  
Zhang Lei ◽  
Sun Yuanyuan
Keyword(s):  
Acute Kidney Injury ◽  
Renal Vein ◽  
Kidney Injury ◽  
Renal Vein Thrombosis ◽  
Vein Thrombosis

Natural History of Renal Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1060-1060
Author(s):  
Waldemar E. Wysokinski ◽  
Izabela Gosk-Bierska ◽  
Krzysztof Karnicki ◽  
Rajiv K. Pruthi ◽  
Robert D. McBane
Keyword(s):  
Venous Thromboembolism ◽  
Mortality Rate ◽  
Natural History ◽  
Renal Vein ◽  
Wilms Tumor ◽  
Case Series ◽  
Renal Vein Thrombosis ◽  
Antiphospholipid Antibody ◽  
Vein Thrombosis ◽  
History Of

Abstract Renal vein thrombosis (RVT), although uncommon, is associated with considerable morbidity and mortality. Neither the etiology nor the natural history of RVT has been adequately described in a large case series. Objective: To determine whether incident RVT is associated with an increased likelihood of recurrent local and systemic venous thromboembolic disease. Methods: Cases were identified by reviewing the Diagnostic Index for all patients with RVT at our institution between 1981 and 2000. Results: The study group consisted of 240 patients (34% women) with a mean age 55± 19 years. The diagnosis of RVT was made by CT (35%), Duplex Ultrasound (35%), MRI±gadolinium (10%) and either at surgery or autopsy in the remainder. The underlying etiology was deemed to be malignancy in 65% of cases. Of these, renal cell carcinoma (74%) and Wilms tumor (3%) made up the majority. Nephrotic syndrome primarily membranous glomerulonephritis was the second most common underlying etiology (23%). Of those tested, a definable thrombophilia was found in only 13 cases including lupus anticoagulant/antiphospholipid antibody (n=4); deficiencies of protein C or S, (n=2 each); heparin induced thrombocytopenia (n=2); antithrombin deficiency, dysfibrinogenemia and hyperhomocysteinemia (n=1 each). Eighty-one patients (34%) were treated with warfarin. Over a mean follow up of 3 years, the rate of recurrence of venous thrombosis at any site was 5%. The mortality rate over this time period was 49%. Conclusion: RVT represents a distinct clinical entity relative to venous thromboembolism of the lower extremity. The observed low rate of recurrence may be explained by the high mortality rate owing to a high percentage of renal malignancy. RVT should prompt an evaluation for an underlying renal malignancy.

scholarly journals Extensive Thrombosis of the Inferior Vena Cava and Left Renal Vein in a Neonate

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Moez Kdous ◽  
Oussema Khlifi ◽  
Marwene Brahem ◽  
Mohamed Khrouf ◽  
Sarah Amari ◽  
...  
Keyword(s):  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Renal Vein Thrombosis ◽  
Heterozygous Mutation ◽  
Renal Ultrasound ◽  
Factor V ◽  
Vein Thrombosis ◽  
The Right

Antenatal renal vein thrombosis is a rarely described diagnostic finding, with variable consequences on kidney function. We present the case of an affected fetus, born at 35-week gestation, with intrauterine oligohydramnios and two small kidneys. A renal ultrasound carried out after birth confirmed the presence of prenatal abnormalities. Renal vein thrombosis was not diagnosed at the time. The baby died 20 days later of kidney failure, metabolic acidosis, and polypnea with severe hypotrophy. Autopsy revealed atrophied kidneys and adrenal glands. The vena cava had thrombosis occupying most of its length. The right renal vein was normal, while the left renal vein was threadlike and not permeable. Histologically, there was necrosis of the left adrenal gland with asymmetrical bilateral renal impairment and signs of ischemic and hemorrhagic lesions. A review of thrombophilia was carried out and a heterozygous mutation in Factor V was found in both the mother and the child.

scholarly journals Stent Placement Across the Renal Vein Inflow in Patients Undergoing Venous Reconstruction Preserves Renal Function and Renal Vein Patency: Experience in 93 Patients

2019 ◽  
Vol 26 (2) ◽  
pp. 258-264 ◽  
Author(s):  
Jeffrey Forris Beecham Chick ◽  
Joseph J. Gemmete ◽  
Anthony N. Hage ◽  
Jacob J. Bundy ◽  
Charles Brewerton ◽  
...  
Keyword(s):  
Renal Function ◽  
Treatment Group ◽  
Stent Placement ◽  
Renal Vein ◽  
Iliac Vein ◽  
Renal Vein Thrombosis ◽  
Control Group ◽  
Venous Disease ◽  
Renal Veins ◽  
Vein Thrombosis

Purpose: To determine if stent placement across the renal vein inflow affects kidney function and renal vein patency. Methods: Between June 2008 and September 2016, 93 patients (mean age 39 years, range 15–70; 54 women) with iliocaval occlusion underwent venous stent placement and were retrospectively reviewed. For this analysis, the patients were separated into treatment and control groups: 51 (55%) patients had suprarenal and infrarenal iliocaval venous disease requiring inferior vena cava stent reconstruction across the renal vein inflow (treatment group) and 42 (45%) patients had iliac vein stenting sparing the renal veins (control group). Treatment group patients received Wallstents (n=15), Gianturco Z-stents (n=24), or suprarenal and infrarenal Wallstents such that the renal veins were bracketed with a “renal gap” (n=12). Stenting technical success, stent type, glomerular filtration rate (GFR), and creatinine before and after stent placement were recorded, along with renal vein patency and complications. Results: All procedures were technically successful. In the 51-patient treatment group, 15 (29%) patients received Wallstents and 24 (47%) received Gianturco Z-stents across the renal veins, while 12 (24%) were given a “renal gap” with no stent placement directly across the renal vein inflow. In the control group, 42 patients received iliac vein Wallstents only. Mean prestent GFR was 59±1.8 mL/min/1.73 m2 and mean prestent creatinine was 0.8±0.2 mg/dL for the entire cohort. Mean prestent GFR and creatinine values in the Wallstent, Gianturco Z-stent, and “renal gap” subgroups did not differ from the iliac vein stent group. Mean poststent GFR and creatinine values were 59±3.3 mL/min/1.73 m2 and 0.8±0.3 mg/dL, respectively. There were no differences between mean pre- and poststent GFR (p=0.32) or creatinine (p=0.41) values when considering all patients or when comparing the treatment subgroups and the control group. There were no differences in the poststent mean GFR or creatinine values between the Wallstent (p=0.21 and p=0.34, respectively) and Gianturco Z-stent (p=0.43 and p=0.41, respectively) groups and the “renal gap” group. One patient with a Wallstent across the renal veins developed right renal vein thrombosis 7 days after the procedure. Conclusion: Stent placement across the renal vein inflow did not compromise renal function. A very small risk of renal vein thrombosis was seen.

scholarly journals Rupture of Renal Transplant

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Shona Baker ◽  
Maria Popescu ◽  
Jacob A. Akoh
Keyword(s):  
Acute Tubular Necrosis ◽  
Renal Allograft ◽  
Graft Function ◽  
Kidney Injury ◽  
Deceased Donor ◽  
Renal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Tubular Necrosis ◽  
Managing Risk ◽  
Old Donor

Background. Rupture of renal allograft is a rare and serious complication of transplantation that is usually attributed to acute rejection, acute tubular necrosis, or renal vein thrombosis.Case Presentation. LD, a 26-year-old male with established renal failure, underwent deceased donor transplantation using kidney from a 50-year-old donor with acute kidney injury (Cr 430 mmol/L). LD had a stormy posttransplant recovery and required exploration immediately for significant bleeding. On day three after transplant, he developed pain/graft swelling and another significant haemorrhage with cardiovascular compromise which did not respond to aggressive resuscitation. At reexploration, the renal allograft was found to have a longitudinal rupture and was removed. Histology showed features of type IIa Banff 97 acute vascular rejection, moderate arteriosclerosis, and acute tubular necrosis.Conclusion. Possible ways of avoiding allograft rupture include use of well-matched, good quality kidneys; reducing or managing risk factors that would predispose to delayed graft function; ensuring a technically satisfactory transplant procedure with short cold and warm ischemia times; and avoiding large donor-recipient age gradients.

Current Guidelines and Strategies in Management of Renal Vein Thrombosis

2013 ◽  
Vol 9 (3) ◽  
pp. 240-249
Author(s):  
Howard H.W. Chan ◽  
Anthony K.C. Chan ◽  
Jan Blatny ◽  
Keith K. Lau
Keyword(s):  
Renal Vein ◽  
Renal Vein Thrombosis ◽  
Vein Thrombosis ◽  
Current Guidelines

Chronic renal vein thrombosis in a renal allograft. Case Report

Nephrology ◽  
2003 ◽  
Vol 8 (5) ◽  
pp. 248-250 ◽  
Author(s):  
WAI H LIM ◽  
GREG VAN SCHIE ◽  
KEVIN WARR
Keyword(s):  
Case Report ◽  
Renal Vein ◽  
Renal Allograft ◽  
Renal Vein Thrombosis ◽  
Vein Thrombosis
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