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Renal Artery Embolization for Bleeding, Angiolipoma, Renal Cell Carcinoma and Certain Medical Conditions

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Therapeutic Embolization

Abstract

Renal artery embolization (RAE) is an effective minimally invasive alternative procedure for the treatment of a variety of surgical and chronic medical renal diseases. It is invaluable in containing bleeding due to iatrogenic and other traumatic causes which otherwise requires nephrectomy. Since the 1970s when RAE was first developed, technical advances and growing experience have expanded the indications to not only include treatment of conditions such as symptomatic hematuria and palliation for metastatic renal cancer, but also preoperative infarction of renal tumors, treatment of angiomyolipomas, vascular malformations, medical renal disease and complications following renal transplantation and biopsy. The availability of more precise embolic agents and smaller delivery catheters, have contributed to the growth of RAE for an exxpanding list of urologic and nephrologic conditions.

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References

  1. Abath C, Andrade G, Cavalcanti D, et al. Complex renal artery aneurysms: liquids or coils? Tech Vasc Interv Radiol. 2007;10:299–307.

    Article  PubMed  Google Scholar 

  2. Manninen HI, Berg M, Vanninen RL. Stent-assisted coil embolization of wide-necked renal artery bifurcation aneurysms. J Vasc Interv Radiol. 2008;19:487–92.

    Article  PubMed  Google Scholar 

  3. Wallace S, Chuang VP, Swanson D, et al. Embolization of renal carcinoma. Radiology. 1981;138:563–70.

    Article  CAS  PubMed  Google Scholar 

  4. Derdeyn C, Graves V, Salamat M, et al. Collagen-coated acrylic microspheres for embolotherapy: in vivo and in vitro characteristics. AJNR Am J Neuroradiol. 1997;18:647–53.

    CAS  PubMed  Google Scholar 

  5. Sofocleous CT, Hinrichs C, Hubbi B, et al. Angiographic findings and embolotherapy in renal arterial trauma. Cardiovasc Intervent Radiol. 2005;28:39–47.

    Article  PubMed  Google Scholar 

  6. Clark TW, Sankin A, Becske T, et al. Stent-assisted Gugliemi detachable coil repair of wide-necked renal artery aneurysm using 3-D angiography. Vasc Endovascular Surg. 2007;41:528–32.

    Article  PubMed  Google Scholar 

  7. Diaz-Buxo JA, Kopen DF, Donadio Jr JV. Renal allograft arteriovenous fistula following percutaneous biopsy. J Urol. 1974;112(5):577–80.

    CAS  PubMed  Google Scholar 

  8. Merkus JW, Zeebregts CJ, Hoitsma AJ, et al. High incidence of arteriovenous fistula after biopsy of kidney allografts. Br J Surg. 1993;80(3):310–2.

    Article  CAS  PubMed  Google Scholar 

  9. Loffroy R, Guiu B, Lambert A, et al. Management of postbiopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes. Clin Radiol. 2008;63(6):657–65.

    Article  CAS  PubMed  Google Scholar 

  10. Hedegard W, Saad WE, Davies MG. Management of vascular and nonvascular complications after renal transplantation. Tech Vasc Interv Radiol. 2009;12(4):240–62.

    Article  PubMed  Google Scholar 

  11. Maleux G, Messiaen T, Stockx L, Vanrenterghem Y, Wilms G. Transcatheter embolization of biopsy-related vascular injuries in renal allografts. Long-term technical, clinical and biochemical results. Acta Radiol. 2003;44(1):13–7.

    CAS  PubMed  Google Scholar 

  12. Dorffner R, Thurnher S, Prokesch R, et al. Embolization of iatrogenic vascular injuries of renal transplants: immediate and follow-up results. Cardiovasc Intervent Radiol. 1998;21(2):129–34.

    Article  CAS  PubMed  Google Scholar 

  13. Sennett CA, Messersmith RN, Yousefzadeh DK, Thistlethwaite Jr JR. Percapsular and percutaneous embolization of renal transplant pseudoaneurysm and AV fistula: case report. Cardiovasc Intervent Radiol. 1989;12(5):270–3.

    Article  CAS  PubMed  Google Scholar 

  14. Ginat DT, Saad WE, Turba UC. Transcatheter renal artery embolization: clinical applications and techniques. Tech Vasc Interv Radiol. 2009;12(4):224–39.

    Article  PubMed  Google Scholar 

  15. Schwartz MJ, Smith EB, Trost DW, Vaughan Jr ED. Renal artery embolization: clinical indications and experience from over 100 cases. BJU Int. 2007;99(4):881–6.

    Article  PubMed  Google Scholar 

  16. Kalman D, Varenhorst E. The role of arterial embolization in renal cell carcinoma. Scand J Urol Nephrol. 1999;33(3):162–70.

    Article  CAS  PubMed  Google Scholar 

  17. Bakal CW, Cynamon J, Lakritz PS, Sprayregen S. Value of preoperative renal artery embolization in reducing blood transfusion requirements during nephrectomy for renal cell carcinoma. J Vasc Interv Radiol. 1993;4(6):727–31.

    Article  CAS  PubMed  Google Scholar 

  18. Klimberg I, Hunter P, Hawkins IF, Drylie DM, Wajsman Z. Preoperative angioinfarction of localized renal cell carcinoma using absolute ethanol. J Urol. 1985;133(1):21–4.

    CAS  PubMed  Google Scholar 

  19. Woodrum DA, Atwell TD, Farrell MA, Andrews JC, Charboneau JW, Callstrom MR. Role of intraarterial embolization before cryoablation of large renal tumors: a pilot study. J Vasc Interv Radiol. 2010;21(6):930–6.

    Article  PubMed  Google Scholar 

  20. Ginat DT, Saad WE, Turba UC. Transcatheter renal artery embolization for management of renal and adrenal tumors. Tech Vasc Interv Radiol. 2010;13(2):75–88.

    Article  PubMed  Google Scholar 

  21. Yamakado K, Nakatsuka A, Kobayashi S, et al. Radiofrequency ablation combined with renal arterial embolization for the treatment of unresectable renal cell carcinoma larger than 3.5 cm: initial experience. Cardiovasc Intervent Radiol. 2006;29(3):389–94.

    Article  PubMed  Google Scholar 

  22. Arima K, Yamakado K, Kinbara H, Nakatsuka A, Takeda K, Sugimura Y. Percutaneous radiofrequency ablation with transarterial embolization is useful for treatment of stage 1 renal cell carcinoma with surgical risk: results at 2-year mean follow up. Int J Urol. 2007;14(7):585–90.

    Article  PubMed  Google Scholar 

  23. Mondshine RT, Owens S, Mondschein JI, Cizman B, Stavropoulos SW, Clark TW. Combination embolization and radiofrequency ablation therapy for renal cell carcinoma in the setting of coexisting arterial disease. J Vasc Interv Radiol. 2008;19(4):616–20.

    Article  PubMed  Google Scholar 

  24. Zielinski H, Szmigielski S, Petrovich Z. Comparison of preoperative embolization followed by radical nephrectomy with radical nephrectomy alone for renal cell carcinoma. Am J Clin Oncol. 2000;23(1):6–12.

    Article  CAS  PubMed  Google Scholar 

  25. Swanson DA, Johnson DE, von Eschenbach AC, Chuang VP, Wallace S. Angioinfarction plus nephrectomy for metastatic renal cell carcinoma—an update. J Urol. 1983;130(3):449–52.

    CAS  PubMed  Google Scholar 

  26. Rimon U, Duvdevani M, Garniek A, et al. Large renal angiomyolipomas: digital subtraction angiographic grading and presentation with bleeding. Clin Radiol. 2006;61(6):520–6.

    Article  CAS  PubMed  Google Scholar 

  27. Hamlin JA, Smith DC, Taylor FC, et al. Renal angiomyolipomas: long-term follow-up of embolization for acute hemorrhage. Can Assoc Radiol J. 1997;48(3):191–8.

    CAS  PubMed  Google Scholar 

  28. Takebayashi S, Horikawa A, Arai M, Iso S, Noguchi K. Transarterial ethanol ablation for sporadic and non-hemorrhaging angiomyolipoma in the kidney. Eur J Radiol. 2009;72(1):139–45.

    Article  PubMed  Google Scholar 

  29. Dabbeche C, Chaker M, Chemali R, et al. Role of embolization in renal angiomyolipomas. J Radiol. 2006;87(12 Pt 1):1859–67.

    Article  CAS  PubMed  Google Scholar 

  30. Ramon J, Rimon U, Garniek A, et al. Renal angiomyolipoma: long-term results following selective arterial embolization. Eur Urol. 2009;55(5):1155–61.

    Article  PubMed  Google Scholar 

  31. Kothary N, Soulen MC, Clark TW, et al. Renal angiomyolipoma: long-term results after arterial embolization. J Vasc Interv Radiol. 2005;16(1):45–50.

    Article  PubMed  Google Scholar 

  32. Soulen MC, Faykus Jr MH, Shlansky-Goldberg RD, Wein AJ, Cope C. Elective embolization for prevention of hemorrhage from renal angiomyolipomas. J Vasc Interv Radiol. 1994;5(4):587–91.

    Article  CAS  PubMed  Google Scholar 

  33. Fisher RG, Ben-menachem Y. Angiography and embolization in renal trauma. In: Baum S, editor. Abram’s angiography: vascular and interventional radiology. 4th ed. Boston: Little, Brown and Company; 1997. p. 1230–43.

    Google Scholar 

  34. Teigen CL, Venbrux AC, Quinlan DM, Jeffs RD. Late massive hematuria as a complication of conservative management of blunt renal trauma in children. J Urol. 1992;147(5):1333–6.

    CAS  PubMed  Google Scholar 

  35. Fisher RG, Ben-Menachem Y, Whigham C. Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. AJR Am J Roentgenol. 1989;152(6):1231–5.

    Article  CAS  PubMed  Google Scholar 

  36. Cope C, Zeit RM. Pseudoaneurysms after nephrostomy. AJR Am J Roentgenol. 1982;139(2):255–61.

    Article  CAS  PubMed  Google Scholar 

  37. Low RN, Jeffrey Jr RB. Intraperitoneal hemorrhage after renal biopsy: a grave prognostic sign. AJR Am J Roentgenol. 1988;151(1):113–4.

    Article  CAS  PubMed  Google Scholar 

  38. Ashenburg RJ, Blair RJ, Rivera FJ, Weigele JB. Renal arterial rupture complicating transluminal angioplasty: successful conservative management. Radiology. 1990;174(3 Pt 2):983–5.

    Article  CAS  PubMed  Google Scholar 

  39. Somani BK, Nabi G, Thorpe P, McClinton S. Endovascular control of haemorrhagic urological emergencies: an observational study. BMC Urol. 2006;6:27.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Nakatani T, Uchida J, Han YS, et al. Renal allograft arteriovenous fistula and large pseudoaneurysm. Clin Transplant. 2003;17(1):9–12.

    Article  PubMed  Google Scholar 

  41. Bach AM, Merton DA, Burke Jr JF, Halpern EJ. Sonographic diagnosis of arteriovenous fistula and pseudoaneurysm after biopsy of a transplanted kidney. J Ultrasound Med. 1993;12(9):545–7.

    CAS  PubMed  Google Scholar 

  42. Horwitz MD, Hanbury DC, King CM. Renal artery pseudoaneurysm following partial nephrectomy treated with stent-graft. Br J Radiol. 2005;78(926):161–3.

    Article  CAS  PubMed  Google Scholar 

  43. Zhang LJ, Yang GF, Qi J, Shen W. Renal artery aneurysm: diagnosis and surveillance with multidetector-row computed tomography. Acta Radiol. 2007;48(3):274–9.

    Article  CAS  PubMed  Google Scholar 

  44. Garg N, Pipinos II, Longo GM, Thorell WE, Lynch TG, Johanning JM. Detachable coils for repair of extraparenchymal renal artery aneurysms: an alternative to surgical therapy. Ann Vasc Surg. 2007;21(1):97–110.

    Article  PubMed  Google Scholar 

  45. Millard FC, Hemingway AP, Cumberland DC, Brown CB. Renal embolization for ablation of function in renal failure and hypertension. Postgrad Med J. 1989;65(768):729–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Keller FS, Coyle M, Rosch J, Dotter CT. Percutaneous renal ablation in patients with end-stage renal disease: alternative to surgical nephrectomy. Radiology. 1986;159(2):447–51.

    Article  CAS  PubMed  Google Scholar 

  47. Hahn ST, Park SH, Lee JM, Kim CY, Chang YS. Renal artery embolization controls intractable pain in a patient with polycystic kidney disease. Cardiovasc Intervent Radiol. 1999;22(5):422–4.

    Article  CAS  PubMed  Google Scholar 

  48. Harley JD, Shen FH, Carter SJ. Transcatheter infarction of a polycystic kidney for control of recurrent hemorrhage. AJR Am J Roentgenol. 1980;134(4):818–20.

    Article  CAS  PubMed  Google Scholar 

  49. Hom D, Eiley D, Lumerman JH, Siegel DN, Goldfischer ER, Smith AD. Complete renal embolization as an alternative to nephrectomy. J Urol. 1999;161(1):24–7.

    Article  CAS  PubMed  Google Scholar 

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Varghese, K., Adhyapak, S. (2017). Renal Artery Embolization for Bleeding, Angiolipoma, Renal Cell Carcinoma and Certain Medical Conditions. In: Therapeutic Embolization. Springer, Cham. https://doi.org/10.1007/978-3-319-42494-1_4

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  • DOI: https://doi.org/10.1007/978-3-319-42494-1_4

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