PURPOSE: The aim of our study was to review our experience and long-term follow-up in the treatment of iatrogenic renal vascular injuries using transcatheter embolisation. MATERIALS AND METHODS: Our retrospective analysis of cases collected in two interventional centres consists of a total of 21 patients who underwent renal arterial embolisation (RAE) for iatrogenic arterial kidney bleeding. Biopsy (n = 4), percutaneous nephrolithotomy (n = 4), nephron-sparing surgery (n = 4), guidewire-induced arterial perforation during coronary angiography or renal stenting (n = 3), percutaneous nephrostomy (n = 3), renal endopyelotomy/pyeloplasty (n = 2) and surgical nephrectomy were the iatrogenic causes. Seven patients presented with haemodynamic instability requiring blood transfusion (33.3%), the remaining were haemodynamically stable (66.7%). Diagnostic renal angiography revealed 9 actively bleeding vessels, 6 pseudoaneurysms, 4 arteriovenous fistulas and 1 arterio-calyceal fistula. In one patient selective renal arteriography was negative probably because the bleeding observed at CT angiography was self-limited. Twenty-one embolisation procedures were performed in 20 patients; one patient required a second embolisation 3 h after the first one. Embolisation was performed with microcoils, polyvinyl alcohol particles, embospheres, spongostan emulsion and vascular plug. RESULTS: The technical success rate was 100%. The overall clinical success rate was 95%. Apart from a patient who died due to disseminated intravascular coagulation, no major complications requiring intensive care treatment were encountered during or after the procedures. No patient required emergency surgery or subsequent surgical treatment. No statistically significant differences in eGFR or renal function stage appeared after RAE. CONCLUSIONS: Percutaneous treatment can be proposed as a first-line treatment in iatrogenic renal arterial injuries, resulting in a safe and effective procedure.
PURPOSE: The aim of our study was to review our experience and long-term follow-up in the treatment of iatrogenic renal vascular injuries using transcatheter embolisation. MATERIALS AND METHODS: Our retrospective analysis of cases collected in two interventional centres consists of a total of 21 patients who underwent renal arterial embolisation (RAE) for iatrogenic arterial kidney bleeding. Biopsy (n = 4), percutaneous nephrolithotomy (n = 4), nephron-sparing surgery (n = 4), guidewire-induced arterial perforation during coronary angiography or renal stenting (n = 3), percutaneous nephrostomy (n = 3), renal endopyelotomy/pyeloplasty (n = 2) and surgical nephrectomy were the iatrogenic causes. Seven patients presented with haemodynamic instability requiring blood transfusion (33.3%), the remaining were haemodynamically stable (66.7%). Diagnostic renal angiography revealed 9 actively bleeding vessels, 6 pseudoaneurysms, 4 arteriovenous fistulas and 1 arterio-calyceal fistula. In one patient selective renal arteriography was negative probably because the bleeding observed at CT angiography was self-limited. Twenty-one embolisation procedures were performed in 20 patients; one patient required a second embolisation 3 h after the first one. Embolisation was performed with microcoils, polyvinyl alcohol particles, embospheres, spongostan emulsion and vascular plug. RESULTS: The technical success rate was 100%. The overall clinical success rate was 95%. Apart from a patient who died due to disseminated intravascular coagulation, no major complications requiring intensive care treatment were encountered during or after the procedures. No patient required emergency surgery or subsequent surgical treatment. No statistically significant differences in eGFR or renal function stage appeared after RAE. CONCLUSIONS: Percutaneous treatment can be proposed as a first-line treatment in iatrogenic renal arterial injuries, resulting in a safe and effective procedure.
Authors: Karl Sam; Gérald Gahide; Gilles Soulez; Marie-France Giroux; Vincent L Oliva; Pierre Perreault; Louis Bouchard; Patrick Gilbert; Eric Therasse Journal: J Vasc Interv Radiol Date: 2011-08-15 Impact factor: 3.464
Authors: Constantinos T Sofocleous; Clay Hinrichs; Basil Hubbi; Elias Brountzos; Sanjeev Kaul; George Kannarkat; Philip Bahramipour; Alison Barone; Daniel G Contractor; Tanmaya Shah Journal: Cardiovasc Intervent Radiol Date: 2005 Jan-Feb Impact factor: 2.740
Authors: R Loffroy; B Guiu; A Lambert; C Mousson; Y Tanter; L Martin; J-P Cercueil; D Krausé Journal: Clin Radiol Date: 2008-02-20 Impact factor: 2.350
Authors: Andrew S Levey; Josef Coresh; Ethan Balk; Annamaria T Kausz; Adeera Levin; Michael W Steffes; Ronald J Hogg; Ronald D Perrone; Joseph Lau; Garabed Eknoyan Journal: Ann Intern Med Date: 2003-07-15 Impact factor: 25.391
Authors: Anthony M Esparaz; Jeffrey A Pearl; Brian R Herts; Justin LeBlanc; Baljendra Kapoor Journal: Semin Intervent Radiol Date: 2015-06 Impact factor: 1.513
Authors: Fabio Corvino; Francesco Giurazza; Gianluca Cangiano; Enrico Cavaglià; Francesco Amodio; Giuseppe De Magistris; Antonio Corvino; Raffaella Niola Journal: Radiol Med Date: 2017-12-18 Impact factor: 3.469
Authors: Anna Maria Ierardi; Chiara Floridi; Carlo Pellegrino; Mario Petrillo; Antonio Pinto; Isabella Iadevito; Erica Golia; Alessandra Perillo; Roberto Grassi; Antonio Rotondo; Gianpaolo Carrafiello Journal: Radiol Med Date: 2014-11-12 Impact factor: 3.469
Authors: Giuseppe Belfiore; Maria Paola Belfiore; Alfonso Reginelli; Raffaella Capasso; Francesco Romano; Giovanni Pietro Ianniello; Salvatore Cappabianca; Luca Brunese Journal: Med Oncol Date: 2017-02-04 Impact factor: 3.064