Survival following late renal embolectomy in a patient with a single functioning kidney

Successful removal of an embolus which totally occluded the main artery of the only functioning kidney is an anuric patient is described. There was an 18 hour delay between the onset of symptoms and embolectomy. Despite this delay adequate renal function returned and supportive dialysis was necessary only in the immediate postoperative period. It is believed that if renal embolism is suspected, a renal arteriogram should be the immediate and only X ray investigation. Once embolism is diagnosed embolectomy should be performed without delay. However, even late embolectomy may be successful due to possible collateral circulation. Backflow and recovery of kidney color are good prognostic signs. Hemodialysis will support the patient until recovery from ischemic tubular necrosis.