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Embolization of renal vascular lesions: Clinical experience with microcoils and tracker catheters

  • Clinical Investigations
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Abstract

After biopsy (n=6) and nephrostomy (n=1) of three native and four transplanted kidneys, gross hematuria, hypertension, and deterioration of function necessitated performance of transarterial embolization. Angiography revealed five arteriovenous fistulas (AVFs), one pseudoaneurysm, and one arteriocaliceal fistula. Superselective catheterization was accomplished using 5 Fr standard diagnostic catheters and 3 Fr coaxial Tracker catheters. Four of five AVFs were embolized successfully by inserting unfibered (2 patients) and fibered (2 patients) platinum coils (diameters 2 mm and 4 mm, respectively). For one AVF, additional injection of butylcyanoacrylate was necessary. The pseudoaneurysm was embolized successfully by such injection, and the arteriocaliceal fistula was occluded using one unfibered 2-mm coil. Embolization stopped the bleeding in all patients. One week after treatment, renal function was improved in 5 patients and remained unaffected in 2. Superselective embolization using Tracker catheters and fibered microcoils is an effective, safe treatment of renal vascular lesions.

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References

  1. Ekelund L, Lindholm T (1971) Arteriovenous fistulae following percutaneous renal biopsy. Acta Radiol 11:38–48

    Article  CAS  Google Scholar 

  2. Bennett AR, Wiener SN (1965) Intrarenal arteriovenous fistula and aneurysm. A complication of percutaneous renal biopsy. AJR 95:372–382

    CAS  Google Scholar 

  3. Hübsch PJS, Mostbeck G, Barton PP, Gritzmann N, Fruehwald FXJ, Schurawitzki H, Kovarik J (1990) Evaluation of arteriovenous fistulas and pseudoaneurysms in renal allografts follwoing percutaneous needle biopsy. Color-coded Doppler sonography versus Duplex Doppler sonography. J Ultrasound Med 9:95–100

    PubMed  Google Scholar 

  4. Benoit G, Charpentier B, Roche A, Bellamy J, Mohamedi D, Fries D (1984) Arteriocalyceal fistula after grafted kidney biopsy. Successful management by selective catheter embolization. Urology 24:487–490

    Article  PubMed  CAS  Google Scholar 

  5. Cope C, Zeit RM (1982) Pseudoaneurysms after nephrostomy. AJR 139:255–261

    PubMed  CAS  Google Scholar 

  6. Altebarmakian VK, Guthinger WP, Yakub YN, Gutierrez OH, Linke CA (1981) Percutaneous kidney biopsies. Complications and their management. Urology 18:118–122

    Article  PubMed  CAS  Google Scholar 

  7. Bookstein JJ, Goldstein HM (1973) Successful management of postbiopsy arteriovenous fistula with selective arterial embolization. Radiology 109:535–536

    PubMed  CAS  Google Scholar 

  8. Clark RA, Gallant TE, Alexander ES (1983) Angiographic management of traumatic arteriovenous fistulas: Clinical results. Radiology 147:9–13

    PubMed  CAS  Google Scholar 

  9. Uflacker R, Paolini RM, Lima S (1984) Management of traumatic hematuria by selective renal artery embolization. J Urol 132:662–667

    PubMed  CAS  Google Scholar 

  10. Fisher RG, Ben-Menachem Y, Whigham C (1989) Stab wounds of renal artery branches: Angiographic diagnosis and treatment by embolization. AJR 152:1231–1235

    PubMed  CAS  Google Scholar 

  11. Kerber W, Freeny PC, Cromwell L, Margolis MT, Correa RJ (1977) Cyanoacrylate occlusion of a renal arteriovenous fistula. AJR 128:663–665

    PubMed  CAS  Google Scholar 

  12. Günther R, Klose K, Thelen M, Jacobi G (1981) Superselektive Embolisation mit Gewebekleber im Urogenitaltrakt. Fortschr Röntgenstr 134:536–539

    Article  Google Scholar 

  13. Kadir S, Marshall FF, White RI, Kaufman SL, Barth KH (1983) Therapeutic embolization of the kidney with detachable silicone balloons. J Urol 129:11–13

    PubMed  CAS  Google Scholar 

  14. Yang PJ, Halbach VV, Higashida RT, Hieshima GB (1988) Platinum wire: A new transvascular embolic agent. AJNR 9:547–550

    PubMed  CAS  Google Scholar 

  15. Meyerowitz MF, Levin DC, Boxt LM (1985) Superselective catheterization of small-caliber arteries with a new high-visibility steerable guide wire. AJR 144:785–786

    Google Scholar 

  16. Okazaki M, Higashihara H, Koganemaru F, Ono H, Hoashi T, Kimura T (1990) A coaxial catheter and steerable guidewire used to embolize branches of the splanchnic arteries. AJR 155:405–406

    PubMed  CAS  Google Scholar 

  17. Schmid T, Sandbichler P, Ausserwinkler M, Pernthaler H, Margreiter R (1989) Vascular lesions after percutaneous biopsies or renal allografts. Transpl Int 2:56–58

    Article  PubMed  CAS  Google Scholar 

  18. Baquero A, Morris MC, Cope C, Raja R, Bannett AD (1985) Selective embolization of vascular complications following renal biopsy of the transplanted kidney. Transpl Proc 27:1751–1754

    Google Scholar 

  19. Juravsky LI, Hunter DW, Casteneda-Zuniga WR, Letourneau JG (1991) Angiographic approaches to diagnosis and treatment of vascular complications of renal transplantation. In: Letourneau JG, Day DL, Ascher NL, (eds). Radiology of organ transplantation. Mosby Year Book, St. Louis, pp 135–144

    Google Scholar 

  20. De Souza NM, Reidy JF, Koffman CG (1991) Arteriovenous fistulas complicating biopsy of renal allografts: Treatment of bleeding with superselective embolization. AJR 156:507–510

    Google Scholar 

  21. Chuang VP, Reuter SR, Walter J, Foley WD, Bookstein JJ (1975) Control of renal hemorrhage by selective arterial embolization. AJR 125:300–306

    CAS  Google Scholar 

  22. Kaufman SL, Martin LG, Zuckerman AM, Koch SR, Silverstein MI, Barton JW (1992) Peripheral transcatheter embolization with platinum microcoils. Radiology 184:369–372

    PubMed  CAS  Google Scholar 

  23. White RI, Kaufman SL, Barth KH, DeCaprio V, Strandbert JD (1979) Embolotherapy with detachable silicone balloons. Radiology 131:619–627

    PubMed  Google Scholar 

  24. Mazer MJ, Baltaxe HA, Wolff GL (1981) Therapeutic embolization of renal artery with Gianturco coils: Limitations and technical pitfalls. Radiology 138:37–46

    PubMed  CAS  Google Scholar 

  25. Olliff S, Thomas S, Karani J, Walters H (1990) Superselective embolization using a coaxial catheter technique. Br J Radiol 63:197–201

    Article  PubMed  CAS  Google Scholar 

  26. Moreau JF, Merland JJ, Descamps JM (1982) Post-biopsy false arterial aneurysm of a transplanted kidney: Treatment by bucrylate transcatheter embolization. J Urol 128:116–118

    PubMed  CAS  Google Scholar 

  27. Berger H, Habersetzer R, Jauch KW, Abendroth D (1987) Katheterembolisation intrarenaler arterio-venöser Fistelbildungen. Chirurg 58:675–677

    PubMed  CAS  Google Scholar 

  28. Reuter SR, Pomeroy PR, Chuang VP, Cho KJ (1976) Embolic control of hypertension caused by segmental renal artery stenosis. AJR 127:389–392

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Eberhard Karls University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076, Tübingen, Germany

    Peter E. Huppert M.D., Stephan H. Duda & Claus D. Claussen

  2. Division of Nephrology, Eberhard Karls University of Tübingen, Otfried-Muller-Strasse 10, D-72076, Tübingen, Germany

    Cristiane M. Erley

  3. Department of Urology, Eberhard Karls University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076, Tübingen, Germany

    Martin Roth

  4. Division of General Surgery, Eberhard Karls University of Tübingen, Hoppe-Seyler-Strasse 3, D-72076, Tübingen, Germany

    Werner Lauchart

  5. Department of Medical Biometry, Eberhard Karls University of Tübingen, Westbahnhofstrasse 3, D-72070, Tübingen, Germany

    Klaus Dietz

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  1. Peter E. Huppert M.D.
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  2. Stephan H. Duda
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  6. Klaus Dietz
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  7. Claus D. Claussen
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Huppert, P.E., Duda, S.H., Erley, C.M. et al. Embolization of renal vascular lesions: Clinical experience with microcoils and tracker catheters. Cardiovasc Intervent Radiol 16, 361–367 (1993). https://doi.org/10.1007/BF02603141

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