Defying the Clock: Restoring Renal Function After 72 Hours of Subacute Renal Thrombosis

Introduction: Acute renal artery occlusion, especially of thrombotic origin, is rare and often challenging to diagnose. Although early revascularisation is generally recommended, the optimal timing of intervention, especially beyond six hours, remains uncertain. Report: . Discussion: A thrombotic aetiology was presumed, based on the patient's cardiovascular history, smoking status, atherosclerotic changes in the renal arteries, and absence of dysrhythmias. While standard practice favours revascularisation within six hours, this case supports that delayed intervention may still be effective in thrombotic occlusions. This aligns with emerging evidence from fenestrated endovascular aortic repair related renal artery thrombosis, which shows favourable outcomes despite delayed treatment. Clinical decisions should therefore consider factors such as preserved renal parenchyma perfusion and distal arterial patency. Timing of revascularisation should be individualised, rather than strictly time dependent.