Diagnosis of Common Iliac Artery Thrombosis and Renal Artery Thrombosis in a Kidney Transplant by Radionuclide Renography

• Published in: Clinical nuclear medicine 2007-12, Vol.32 (12), p.944-946
• Main Authors: Sainz-Esteban, Aurora, Banzo, Ignacio, Quirce, Remedios, Jiménez-Bonilla, Julio, Martínez-Rodríguez, Isabel, Barragán, Jorge, Carril, Jose M
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - etiology; Acute Kidney Injury - surgery; Anastomosis, Surgical; Aneurysm, Dissecting - etiology; Aneurysm, Dissecting - physiopathology; Female; Graft Occlusion, Vascular - etiology; Graft Occlusion, Vascular - surgery; Humans; Iliac Artery - diagnostic imaging; Iliac Artery - injuries; Iliac Artery - physiopathology; Kidney Transplantation - adverse effects; Medical Errors; Middle Aged; Radioisotope Renography; Renal Artery - diagnostic imaging; Renal Artery - physiopathology; Renal Artery Obstruction - diagnostic imaging; Renal Artery Obstruction - etiology; Technetium Tc 99m Mertiatide; Thrombosis - diagnostic imaging; Thrombosis - etiology
• ISSN: 0363-9762; 1536-0229
• DOI: 10.1097/RLU.0b013e31815969fb

In a 58-year-old woman, the external iliac artery was accidentally dissected during the arterial anastomosis of a kidney transplant. An immediate CT angiogram showed an almost total occlusion of the common iliac artery. After the transplantation, radionuclide renography with Tc-99m MAG3 showed no flow across the right common iliac artery and no graft vascularization. Sequential images showed a photopenic area corresponding to the renal graft. These findings were interpreted as common iliac artery thrombosis and renal artery thrombosis associated with renal graft infarct. Excision of the transplant and iliofemoral bypass were performed. Pathologic examination of the graft showed massive acute renal infarct and renal artery thrombosis.