CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S6
DOI: 10.1055/s-0041-1730662
Abstract

Iatrogenic Renal Vascular Injuries, Angiographic Findings, and Embolization

Ahmed Sayed Awad
Kasr Alainy Cairo University, Cairo, Egypt
,
Amr Nassef
Kasr Alainy Cairo University, Cairo, Egypt
› Author Affiliations

Background: Renal vascular injuries mostly result from interventional urologic procedures such as percutaneous biopsy and nephrostomy. Serious hemorrhagic complications associated with percutaneous urologic procedures occur in 2.3%–15% of the patients endangering patients' life. Conventional surgical treatment including partial and total nephrectomy carries great morbidity and results in a remarkable renal parenchymal loss. With the development of transcatheter endovascular interventional procedures, microcatheters and embolizing materials precise localization and superselective catheterization of the arterial bleeder followed by embolization gives a minimally invasive treatment option which is able to control bleeding with minimal parenchymal loss and complication compared to surgery. Methods: This work included 64 patients (50 males and 14 females) between the ages of 3 and 60 years (mean age 37 years) with suspected renal vascular injury after renal intervention. They were underwent angiography and percutaneous transcatheter arterial embolization using coils and glue. Results: The source of bleeding was identified and embolized in 56 (87.5%) of patients (pseudoaneurysm = 34, pseudoaneurysm with arteriovenous fistula = 14, arteriovenous fistula alone = 4, and extravasation = 4). Bleeding stopped in 54 of the 56 patients (96.4%). In two patients (3.6%), recurrent bleeding occurred. Re-angiography and assessment were done and insertion of another coil was needed in one patient, whereas in the second one, glue was administrated. None of the patients underwent embolization required further surgical intervention. No significant immediate or delayed complications related to angiography or embolization was recorded. Conclusion: The endovascular embolization is an effective therapeutic technique in iatrogenic renal vascular injuries.



Publication History

Article published online:
11 May 2021

© 2018. The Arab Journal of Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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