Renal venous diversion: An unusual treatment for renal vein thrombosis

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Presentation transcript:

Renal venous diversion: An unusual treatment for renal vein thrombosis Karen J. Ho, MD, Christopher D. Owens, MD, Stephen M. Ledbetter, MD, MPH, David K. Chew, MD, Michael Belkin, MD Journal of Vascular Surgery Volume 43, Issue 6, Pages 1283-1286 (June 2006) DOI: 10.1016/j.jvs.2006.01.032 Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 1 (A) A T1-weighted coronal magnetic resonance image of the abdomen reveals an exophytic mass in the lower pole of the right kidney with tumor thrombus extension into the right renal vein and infrahepatic inferior vena cava (IVC; arrowheads). (B) Despite exploration and thrombectomy of the IVC and left renal vein at the time of radical right nephrectomy, the patient developed recurrent thrombosis of both the IVC and left renal vein (arrowhead), as seen on this post–gadolinium infusion axial magnetic resonance image. Journal of Vascular Surgery 2006 43, 1283-1286DOI: (10.1016/j.jvs.2006.01.032) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 2 Intraoperative view of the inferior mesenteric vein–left renal vein anastomosis (arrowhead). The patient’s head is toward the top. Journal of Vascular Surgery 2006 43, 1283-1286DOI: (10.1016/j.jvs.2006.01.032) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions

Fig 3 Noncontrast abdominal computed tomographic scan obtained 3 months after surgery shows a normal-caliber left renal vein draining into a markedly dilated IMV (arrowheads) on successive transverse sections, which can be traced to the portal vein (not shown). There is no inflammatory stranding around the bypass graft or differential density in the renal vein or inferior mesenteric vein lumen to suggest thrombosis. There is no hydronephrosis. Journal of Vascular Surgery 2006 43, 1283-1286DOI: (10.1016/j.jvs.2006.01.032) Copyright © 2006 The Society for Vascular Surgery Terms and Conditions