Literature DB >> 19233429

Percutaneous embolization for the management of grade 5 renal trauma in hemodynamically unstable patients: initial experience.

M Eric Brewer1, Bradley T Strnad, Brian J Daley, Ryan P Currier, Frederick A Klein, Joe D Mobley, Edward D Kim.   

Abstract

PURPOSE: We evaluated the efficacy and safety of percutaneous embolization for the treatment of grade 5 renal injuries secondary to blunt trauma in patients who are hemodynamically unstable.
MATERIALS AND METHODS: This study was a retrospective analysis of grade 5 blunt renal trauma managed with percutaneous embolization between October 2004 and December 2007. Technical success was defined as complete occlusion of all renovascular bleeding at the end of the procedure. Clinical success was defined as the stabilization of vital signs and absence of need for further surgical or radiological intervention.
RESULTS: Nine patients (6 male and 3 female) with grade 5 renal injury secondary to blunt trauma were treated with percutaneous embolization. These patients did not require surgery for other intra-abdominal injuries. Mean patient age was 30 years (median 34, range 5 to 56, SD 15). Mean hospital length of stay was 18 days (median 13, range 5 to 46, SD 14). Mean units of packed red blood cells transfused for each patient was 6 (median 5, range 0 to 17, SD 5) with 2 receiving none. Technical success was achieved in all patients (100%) and all showed complete resolution of active extravasation on angiography. Clinical success was achieved in all patients (100%) with none requiring further intervention.
CONCLUSIONS: Percutaneous embolization for the management of grade 5 renal injuries is safe and effective with an excellent success rate in our series. The overall complication rate is minimal. Larger studies with long-term followup are needed to assure durability and efficacy.

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Year:  2009        PMID: 19233429     DOI: 10.1016/j.juro.2008.11.100

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  21 in total

1.  Urotrauma: AUA guideline.

Authors:  Allen F Morey; Steve Brandes; Daniel David Dugi; John H Armstrong; Benjamin N Breyer; Joshua A Broghammer; Bradley A Erickson; Jeff Holzbeierlein; Steven J Hudak; Jeffrey H Pruitt; James T Reston; Richard A Santucci; Thomas G Smith; Hunter Wessells
Journal:  J Urol       Date:  2014-05-20       Impact factor: 7.450

Review 2.  Grade IV renal trauma management. A revision of the AAST renal injury grading scale is mandatory.

Authors:  P Chiron; E Hornez; G Boddaert; M Dusaud; Y Bayoud; B Molimard; F R Desfemmes; X Durand
Journal:  Eur J Trauma Emerg Surg       Date:  2015-05-19       Impact factor: 3.693

3.  Conservative Management of High-grade Renal Trauma Does Not Lead to Prolonged Hospital Stay.

Authors:  Lindsay A Hampson; Kushan D Radadia; Anobel Y Odisho; Jack W McAninch; Benjamin N Breyer
Journal:  Urology       Date:  2018-04-02       Impact factor: 2.649

4.  Embolization in trauma: principles and techniques.

Authors:  Jorge E Lopera
Journal:  Semin Intervent Radiol       Date:  2010-03       Impact factor: 1.513

5.  Selective angioembolization for traumatic renal injuries: a survey on clinician practice.

Authors:  Allison S Glass; Ayesha A Appa; Stacey A Kenfield; Herman S Bagga; Sarah D Blaschko; James B McGeady; Jack W McAninch; Benjamin N Breyer
Journal:  World J Urol       Date:  2013-09-27       Impact factor: 4.226

Review 6.  Renal artery embolization-indications, technical approaches and outcomes.

Authors:  Arnaud Muller; Olivier Rouvière
Journal:  Nat Rev Nephrol       Date:  2014-12-23       Impact factor: 28.314

Review 7.  Endovascular management of arterial injuries after blunt or iatrogenic renal trauma.

Authors:  Romaric Loffroy; Olivier Chevallier; Sophie Gehin; Marco Midulla; Pierre-Emmanuel Berthod; Christophe Galland; Pascale Briche; Céline Duperron; Nabil Majbri; Christiane Mousson; Nicolas Falvo
Journal:  Quant Imaging Med Surg       Date:  2017-08

8.  [Clinical experience in the diagnosis and treatment of kidney trauma].

Authors:  K Appelt; K Eisenbrandt; G Lampanaris; D Fahlenkamp
Journal:  Urologe A       Date:  2011-06       Impact factor: 0.639

9.  The role of interventional radiology in urologic tract trauma.

Authors:  Naganathan B S Mani; Lauren Kim
Journal:  Semin Intervent Radiol       Date:  2011-12       Impact factor: 1.513

Review 10.  The role of interventional radiology in abdominopelvic trauma.

Authors:  Anna Maria Ierardi; Ejona Duka; Natalie Lucchina; Chiara Floridi; Alessandro De Martino; Daniela Donat; Federico Fontana; Gianpaolo Carrafiello
Journal:  Br J Radiol       Date:  2016-01-05       Impact factor: 3.039

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