MP3-01 SELECTIVE ARTERIAL EMBOLIZATION IN RENAL TRAUMA: THE PUERTO RICO TRAUMA CENTER EXPERIENCE

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Trauma & Reconstructive Surgery II1 Apr 2014MP3-01 SELECTIVE ARTERIAL EMBOLIZATION IN RENAL TRAUMA: THE PUERTO RICO TRAUMA CENTER EXPERIENCE Jose Silva, Antonio Puras, Marcos Perez, and Fernando Joglar Jose SilvaJose Silva More articles by this author , Antonio PurasAntonio Puras More articles by this author , Marcos PerezMarcos Perez More articles by this author , and Fernando JoglarFernando Joglar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.180AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The kidneys are the most common genitourinary organs affected from external trauma. Low-grade renal injuries are typically managed conservatively. Although most high-grade renal injuries require surgical interventions, their treatment still lacks standardized management. Furthermore, the treatment algorithm in some of the most prominent Urological publications fail to mention selective renal artery embolization as a feasible alternative. METHODS We retrospectively reviewed the trauma registry of the Puerto Rico Trauma Center for all patients treated for renal trauma (ICD-9 codes 866.0, 866.02, 866.10, and 866.12) between January 1, 2007 and December 31, 2010. We performed an extensive chart review to asses all the multiple variables involved and for further characterization of these injuries. RESULTS Of 7,291 total admission to Trauma Hospital, 215 included kidney lacerations. Trauma to male gender represented most of renal trauma with 92% (198/215). Blunt trauma represented more than half of all injuries with 58% (125/215) cases while penetrating trauma only 42% (90/215). Forty two percent (90/215) of all kidney lacerations underwent exploratory laparotomy by Trauma Surgery Staff, including renal exploration. Of the 215 patients, a total of 12 patients underwent selective renal artery embolization for their renal injuries. None of these patients required OR interventions or exploratory laparotomy. Sixty seven percent of the patients (8/12) sustained blunt trauma while 33% (4/12) suffered a penetrating injury. Grade V renal laceration was seen in 38% (3/8) of the total patients with blunt trauma. Fifty percent (4/8) of patients with grade III renal laceration underwent embolization due to active blush of IV contrast on CT scan. Of the patients that sustained penetrating injury, seventy five percent (3/4) sustained stab wounds while the remaining 25% (1/4) had gunshot injury. Two patients (67%, n=3) with stab wound injuries developed pseudoaneurysms, which required selective renal artery embolization. All had an unremarkable post-procedural hospital course with no complications from the embolization procedure. CONCLUSIONS Selective renal artery embolization is a feasible and less invasive procedure than conventional open surgical approaches in the management of renal trauma in select patients. At present and based on availability, selective renal artery embolization should be considered as first line treatment for high-grade renal lacerations in patients not undergoing exploratory laparotomy for other associated traumatic injuries. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e34 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jose Silva More articles by this author Antonio Puras More articles by this author Marcos Perez More articles by this author Fernando Joglar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...