Massive Hemorrhage From Renal Vein Injury During Percutaneous Renal Surgery: Endourological Management

Abstract

Although minor venous injuries respond to simple maneuvers, major venous injuries pose a significant therapeutic problem and may be under diagnosed. We present our experience with major injury to the renal vein during percutaneous renal surgery. Four patients had massive hemorrhage during percutaneous renal surgery associated with major injury to the renal vein, and 3 also had renal insufficiency. All 4 patients and 1 additional patient with renal insufficiency and massive hemorrhage from an arteriovenous fistula following percutaneous renal surgery were treated nonoperatively with a selectively positioned and inflated Council balloon catheter. Hemorrhage was controlled and renal function was unaffected in all 5 patients. Renal vein injuries can be associated with massive hemorrhage. Patients with major vascular injuries from percutaneous renal surgery and concomitant renal insufficiency can be treated without open exploration or angiographic embolization using a Council balloon catheter.