Endovascular Management of Iatrogenic Native Renal Arterial Pseudoaneurysms
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Our purpose was to evaluate iatrogenic renal pseudoaneurysms, endovascular treatment, and outcomes.
This retrospective study (2003–2011) reported the technical and clinical outcomes of endovascular therapy for renal pseudoaneurysms in eight patients (mean age, 46 (range 24–68) years). Renal parenchymal loss evaluation was based on digital subtraction angiography and computed tomography.
We identified eight iatrogenic renal pseudoaneurysm patients with symptoms of hematuria, pain, and hematoma after renal biopsy (n = 3), surgery (n = 3), percutaneous nephrolithotomy (n = 1), and endoscopic shock-wave lithotripsy (n = 1). In six patients, the pseudoaneurysms were small-sized (<20 mm) and peripherally located and were treated solely with coil embolization (n = 5). In one patient, coil embolization was preceded by embolization with 500–700 micron embospheres to control active bleeding. The remaining two patients had large-sized (≥50 mm), centrally located renal pseudoaneurysms treated with thrombin ± coils. Technical success with immediate bleeding cessation was achieved in all patients. There were no procedure-related deaths or complications (mean follow-up, 23.5 (range, 1–67) months).
Treatment of renal pseudoaneurysms using endovascular approach is a relatively safe and viable option regardless of location (central or peripheral) and size of the lesions with minimal renal parenchymal sacrifice.
KeywordsEmbolization Embolotherapy Artery Kidney/renal
The authors declare that there was no financial support for this project.
Conflict of interest
The authors declare that there was no conflict of interest for this project.
Disclosure unrelated to this article
Alan H. Matsumoto; Grant support: NIH, W.L. Gore, Medtronic, Cook, Insightec, Endologix. DSMB activities: Trivascular, Bolton Medical. Advisory Board/ Consultant, Siemens Medical, St Judes Medical, Boston Scientific, Crux Medical, Bard Peripheral Vascular. Other authors; None.