Mortality and renal salvage after renovascular trauma. A review of 94 patients treated in a 20 year period

Ninety-four patients with 96 renovascular injuries underwent operations over a 20 year period. Forty-nine patients had renal artery injury, 45 had isolated venous injury, and 33 had both vessels injured. Arterial revascularization succeeded in four patients, failed in five, and the results were not documented in three. Revascularization of acute renal artery thromboses was unsuccessful. Isolated renal vein injuries were repaired in 28 patients. The mortality rate was 37 percent for renal artery injuries and 28 percent for isolated renal vein injuries, despite the frequent choice of nephrectomy instead of reconstruction in unstable patients. Renal salvage was accomplished in 10 percent of patients with renal artery injury and in 51 percent of patients with isolated renal vein injury. Renal salvage is not often feasible in patients with renal arterial injuries because of associated renal vein injuries. The success of revascularization of traumatically occluded renal arteries is low and should probably be attempted only in unusual circumstances, such as bilateral injuries. Most isolated renal vein injuries are repairable, and reconstruction should be attempted in stable patients.