Blunt renal artery trauma: How should it be treated, or rather, should it be treated?

摘要

One hundred and fifty years after its first description, the treatment of renal artery occlusion secondary to trauma is still controversial. Although some reviews report a high success rate with revascular-ization [2], more recent series suggest that restoring normal renal function is unlikely when the main renal artery is injured [3,4]. The success of any arterial reconstruction is related to the duration and degree of ischemia, presence or absence of collateral arteries, and the complexity of the repair. Warm kidney ischemia of more than 2 hours causes irreversible tissue damage, but collateral circulation via the renal capsular, peripelvic and periureteric vessels as well as a patent renal vein may extend the kidney viability beyond the 2 hour time limit [5]. Moreover, the success of renal artery reconstruction is difficult to interpret as outcomes have not been consistently defined and follow-up tends to be poor in these patients.