Document Detail


The local lysis therapy of spontaneous renal artery dissection with arterial thrombosis
MedLine Citation:
PMID:  1644015     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 33-year-old previously completely healthy man developed severe, at first colicky then persisting, pain in the left flank. The blood pressure was 190/110 mm Hg and he had pain over the left kidney on percussion. There was a mild leucocytosis (10,300/microliters), serum creatinine of 1.5 mg/dl and a rise in lactate dehydrogenase level to 395 U/l, while the urine was unremarkable. The pyelogram demonstrated on the left the upper calyceal system only and this very weakly. Colour Doppler ultrasound showed a massively reduced blood flow in the left renal vein while the artery was not visible. Digital subtraction angiography demonstrated eccentric narrowing of the left renal artery by an intravascular thrombus, providing the diagnosis of spontaneous renal artery dissection with thrombosis. Complete recanalization occurred after local thrombolysis with 500,000 IU urokinase over 7 hours, and subsequent administration of four times 40 mg tissue plasminogen activator over 4 hours. But the scintigram still demonstrated impaired renal function with decrease in clearance to 10% of total. The patient was still symptom-free on re-examination 16 months later, serum creatinine concentration was stable at 1.3 mg/dl and the blood pressure was normal.
Authors:
R M Klein; R Niehues; M Hollenbeck; D Horstkotte; G Fürst; B E Strauer
Publication Detail:
Type:  Case Reports; English Abstract; Journal Article    
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  117     ISSN:  0012-0472     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-09-09     Completed Date:  1992-09-09     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  GERMANY    
Other Details:
Languages:  ger     Pagination:  1185-90     Citation Subset:  IM    
Affiliation:
Abteilung für Kardiologie, Pneumologie und Angiologie, Universität Düsseldorf.
Vernacular Title:
Lokale Lyse-Therapie bei spontaner Nierenarteriendissektion mit arterieller Thrombose.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aneurysm, Dissecting / diagnosis,  drug therapy*
Drug Therapy, Combination
Emergencies
Humans
Male
Renal Artery* / radiography,  ultrasonography
Renal Artery Obstruction / diagnosis,  drug therapy*
Thrombolytic Therapy*
Thrombosis / diagnosis,  drug therapy*
Tissue Plasminogen Activator / administration & dosage*
Urokinase-Type Plasminogen Activator / administration & dosage*
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.73/Urokinase-Type Plasminogen Activator
Comments/Corrections
Comment In:
Dtsch Med Wochenschr. 1992 Nov 6;117(45):1739   [PMID:  1425291 ]

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