Transarterial embolization in treatment of iatrogenic renal hemorrhage

Abstract

Objective To evaluate the safety and efficacy of interventional techniques for emergent treatment of iatrogenic renal vascular injuries. Methods Thirty-four patients with iatrogenic renal vascular injuries were treated with transarterial embolization (TAE). A total of 14 had history of renal biopsy, 8 had partial nephrectomy, 8 had percutaneous nephrolithotomy (PCNL), 3 had percutaneous nephrostomy (PNT), and 1 had percutaneous argon-helium knife. The embolic materials include metallic coils, N-butyl cyanoacrylate (NBCA) iodized oil mixture, polyvinyl alcohol particles (PVA) and gelfoam were used. Results Renal angiogram revealed the pseudoaneurysm in 21 cases, the arteriovenous fistula in 8 cases, and contrast media extravasation in 10 cases. The successful rate of technical was 100%. Medical successes were achieved in 30 patients, and discharged in 30 days later after the embolizations. Four patients died in 10 days later after the embolizations, and all of them accompanied with hemorrhagic shock. Follow-up time ranged from 5—48 months, all of the 30 patients have no re-bleeding and other serious complications, but 16 patients died of primary disease. Conclusions TAE is a safe and effective treatment method for iatrogenic renal vascular injuries. Key words: Kidney injury; Angiography; Embolization, therapeutic