H R Tinto1, M Di Primio2, L Tselikas2, A Palomera Rico2, O Pellerin2, J-Y Pagny2, M Sapoval3. 1. Radiology Department, Hospital de São José, Rua José António Serrano, 1150 Lisboa, Portugal; Radiology Department, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal. Electronic address: hugo.tinto@gmail.com. 2. Interventional Radiology Department, Hôpital Européen Georges-Pompidou, 75015 Paris, France. 3. Interventional Radiology Department, Hôpital Européen Georges-Pompidou, 75015 Paris, France; Radiology Department, Université Paris V-Paris Descartes, Paris, France.
Abstract
PURPOSE: Partial nephrectomy (PN) is an accepted alternative to radical nephrectomy for nephron sparing surgery to treat renal tumors. Although complications are relatively rare after PN, they may include renal hemorrhage that can be massive and life threatening. Artery embolization can have a major role in the management of these cases and to avoid radical nephrectomy. MATERIALS AND METHODS: We report four consecutive patients with massive hemorrhage after PN, treated by arterial embolization and review the literature to discuss the clinical presentation, imaging evaluation and clinical outcome. All patients developed arteriovenous fistula and one a pseudoaneurysm. RESULTS: After selective catheterization and identification of the bleeding site, we used microcoils as embolization material. Immediate technical and clinical success was achieved in all cases. CONCLUSION: Superselective artery embolization of renal hemorrhage is a simple, safe and efficient procedure. It has a high clinical success and should be considered as an alternative to nephrectomy, minimizing the morbidity and preserving renal tissue.
PURPOSE: Partial nephrectomy (PN) is an accepted alternative to radical nephrectomy for nephron sparing surgery to treat renal tumors. Although complications are relatively rare after PN, they may include renal hemorrhage that can be massive and life threatening. Artery embolization can have a major role in the management of these cases and to avoid radical nephrectomy. MATERIALS AND METHODS: We report four consecutive patients with massive hemorrhage after PN, treated by arterial embolization and review the literature to discuss the clinical presentation, imaging evaluation and clinical outcome. All patients developed arteriovenous fistula and one a pseudoaneurysm. RESULTS: After selective catheterization and identification of the bleeding site, we used microcoils as embolization material. Immediate technical and clinical success was achieved in all cases. CONCLUSION: Superselective artery embolization of renal hemorrhage is a simple, safe and efficient procedure. It has a high clinical success and should be considered as an alternative to nephrectomy, minimizing the morbidity and preserving renal tissue.