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Aktuelle Kardiologie 2013; 2(1): 43-46
DOI: 10.1055/s-0032-1328149
Kasuistik
Georg Thieme Verlag KG Stuttgart · New York

Nierenarterienembolie als klinische Erstmanifestation von paroxysmalem Vorhofflimmern

Renal Artery Embolism as a First Clinical Manifestation of Paroxysmal Atrial Fibrillation
F. Kasch
1   Medizinische Abteilung, Kardiologie, Asklepios Klinik Harburg, Hamburg
,
B. Leithäuser
2   Neuro-Kardiologie im Zentrum, Hamburg
,
J.-W. Park
1   Medizinische Abteilung, Kardiologie, Asklepios Klinik Harburg, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2013 (online)

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Zusammenfassung

Der Bericht beschreibt den Fall einer spät erkannten kardiogenen Nierenarterienembolie bei Erstdiagnose von paroxysmalem Vorhofflimmern. Die Therapie erfolgte in Form einer kathetergestützten lokoregionalen Thrombolyse unter Verwendung von Gewebsplasminogenaktivator (rt-PA) und Bivalirudin zur prozeduralen Antikoagulation mit erfolgreicher Rekanalisation. Im Bereich der peripher-arteriellen Interventionen findet sich für diese Kombination bisher keine Erwähnung in der Literatur. Aufgrund der langen zeitlichen Überschreitung der Ischämietoleranz resultierte ein Funktionsausfall der betroffenen Niere trotz erfolgreicher Rekanalisation.

Abstract

A case of delayed diagnosis of cardiogenic renal embolism as a first clinical manifestation of paroxysmal atrial fibrillation is reported. Successful recanalization was achieved with catheter-directed local thrombolysis with tissue plasminogen activator (rt-PA) together with procedural anticoagulation with bivalirudin. Up to now, no publication describes the therapeutic use of this combination in the field of peripheral aterial interventions. Despite arterial recanalization the affected kidney lost its function because the ischemia tolerance period was exeeded.

Schlüsselwörter

Nierenarterie - Embolie - Vorhofflimmern - Katheter-Lyse - Bivalirudin

Key words

renal artery - embolism - atrial fibrillation - catheter lysis - bivalirudin
 

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