Hibernating kidney: CEUS proofing kidney viability after renal artery occlusion in EVAR

A 72-year old male patient underwent endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm, developed acute renal failure with dialysis dependency and was transferred to our unit. Colour coded duplex sonography showed high-grade renal artery stenosis of the right renal artery with an ischemic shrunken kidney. The left renal artery could not be visualized, arterial signals in the periphery were absent. Contrast enhanced ultrasound, however, disclosed slowed, but complete perfusion of the renal parenchyma without signs of infarction. Angiography proofed renal artery stenosis of the right kidney and o…