Abstract 11685: New Intervention Therapy Of Acute Renal Infarction Caused By Atrial Fibrillation: A Case Report

Introduction:Atrial fibrillation is one of the most common arrhythmias, and its thrombotic complications are mainly stroke, but rarely cause acute renal infarction. The low incidence and the non-specific clinical manifestations of acute renal infarction make it difficult to diagnose or even misdiagnosed. The traditional treatment strategy includes antiplatelet, anticoagulant, thrombolysis even open surgery. Thrombectomy and stent implantation have also been reported. Here, we reported that acute renal infarction similar to that of acute myocardial infarction which would be benefited from a combinational treatment of local thrombus aspiration, angioplasty, and infusion of drugs.Clinical Vignette:A 66-year-old man with coronary artery disease and atrial fibrillation. Laboratory analysis showed that elevated lactate dehydrogenase and alpha-hydroxybutyrate dehydrogenase (HBDH) after abdominal pain. Contrast-enhanced CT scan showed renal infarction (Figure 1). The renal angiography showed left renal artery upper and lower branches distal occlusion (Figure 2A). We immediately started the left renal artery interventional treatment. After thrombus was aspirated by a suction catheter and 10 mg nitroglycerin and 1 mg diltiazem were injected through the microcatheter, the angiography showed that the superior and lower branch vessels were developed and restored blood flow (Figure 2B). The symptom of abdominal pain was quickly relieved after the operation. There was no renal dysfunction in the patient during the follow-up period. In conclusion, we present this case with a combination of local thrombus aspiration, angioplasty, and infusion of drugs have achieved successful results for the treatment of the acute renal infarction.