Skip to main content
SpringerLink
Log in

Superselective renal artery embolization in the treatment of renal hemorrhage

  • Original Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Renal hemorrhage is a potentially life-threatening event that may follow trauma, operation, biopsy, and sudden spontaneous rupture of renal tumors or aneurysms. Superselective renal artery embolization (SRAE) is a well-established method for such cases.

Objectives

To assess the effectiveness of SRAE in the treatment of renal hemorrhage at our institute.

Materials and methods

We respectively reviewed the medical records of patients who underwent SRAE for renal hemorrhage from January 2005 to June 2012. Data on patients’ characteristics, indications, requirement of pre-embolization blood transfusion, angiographic finding, location of bleeding site, embolization agents, post-embolization transfusion requirement, complications and the outcome were recorded.

Results

A total of 46 patients, aged 26–73 years, underwent SRAE because of hemorrhage after percutaneous nephrolithotomy (n = 25), partial nephrectomy (n = 6), renal biopsy (n = 2), trauma (n = 2), rupture of angiomyolipoma (n = 4), renal aneurysm (n = 1), and renal ateriovenous malformations (n = 6). A total of 41 patients (80.8 %) underwent successful embolization. Treatment failed in 5 patients with hemorrhage caused by percutaneous nephrolithotomy. Of these, four patients underwent a secondly superselective embolization and had a successful outcome. The remaining one was managed by conservative therapy with repeated blood transfusions. No patient required nephrectomy to save the life of the patient. No serious procedure-related complications occurred.

Conclusions

SRAE is an effective and minimal invasive method for the control of renal hemorrhage. Our experience strongly recommended the first-line use of SRAE for severe renal hemorrhage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. McAninch JW, Carroll PR, Klosterman PW, Dixon CM, Greenblatt MN (1991) Renal reconstruction after injury. J Urol 145:932–937

    CAS  PubMed  Google Scholar 

  2. Breyer BN, McAninch JW, Elliott SP, Master VA (2008) Minimally invasive endovascular techniques to treat acute renal hemorrhage. J Urol 179:2248–2252 discussion 2253

    Article  PubMed  Google Scholar 

  3. Beaujeux R, Saussine C, al-Fakir A et al (1995) Superselective endo-vascular treatment of renal vascular lesions. J Urol 153:14–17

    Article  CAS  PubMed  Google Scholar 

  4. Guglielmi G, Benati A, Perini S (2006) Endovascular embolization with radiopaque silk threads: a feasibility study in Swine. Interv Neuroradiol 12:109–112

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Dehdashti AR, Muster M, Reverdin A, de Tribolet N, Ruefenacht DA (2001) Preoperative silk suture embolization of cerebral and dural arteriovenous malformations. Neurosurg Focus 11:e6

    Article  CAS  PubMed  Google Scholar 

  6. Martin X, Murat FJ, Feitosa LC et al (2000) Severe bleeding after nephrolithotomy: results of hyperselective embolization. Eur Urol 37:136–139

    Article  CAS  PubMed  Google Scholar 

  7. Kessaris DN, Bellman GC, Pardalidis NP, Smith AG (1995) Management of hemorrhage after percutaneous renal surgery. J Urol 153:604–608

    Article  CAS  PubMed  Google Scholar 

  8. Phadke RV, Sawlani V, Rastogi H et al (1997) Iatrogenic renal vascular injuries and their radiological management. Clin Radiol 52:119–123

    Article  CAS  PubMed  Google Scholar 

  9. Takebayashi S, Hosaka M, Kubota Y et al (1998) Transarterial embolization and ablation of renal arteriovenous malformations: efficacy and damages in 30 patients with long-term followup. J Urol 159:696–701

    Article  CAS  PubMed  Google Scholar 

  10. de Luca S, Terrone C, Rossetti SR (1999) Management of renal angiomyolipoma: a report of 53 cases. BJU Int 83:215–218

    Article  PubMed  Google Scholar 

  11. Bookstein JJ, Ernst CB (1973) Vasodilatory and vasoconstrictive pharmacoangiographic manipulation of renal collateral flow. Radiology 108:55–59

    CAS  PubMed  Google Scholar 

  12. Chuang VP, Reuter SR, Walter J, Foley WD, Bookstein JJ (1975) Control of renal hemorrhage by selective arterial embolization. Am J Roentgenol Radium Ther Nucl Med 125:300–306

    Article  CAS  PubMed  Google Scholar 

  13. Sullivan RR, Johnson MB, Lee KP, Ralls PW (1991) Color Doppler sonographic findings in renal vascular lesions. J Ultrasound Med 10:161–165

    CAS  PubMed  Google Scholar 

  14. Cantasdemir M, Adaletli I, Cebi D et al (2003) Emergency endovascular embolization of traumatic intrarenal arterial pseudoaneurysms with N-butyl cyanoacrylate. Clin Radiol 58:560–565

    Article  CAS  PubMed  Google Scholar 

  15. Pappas P, Leonardou P, Papadoukakis S et al (2006) Urgent superselective segmental renal artery embolization in the treatment of life-threatening renal hemorrhage. Urol Int 77:34–41

    Article  PubMed  Google Scholar 

  16. Jain V, Ganpule A, Vyas J et al (2009) Management of non-neoplastic renal hemorrhage by transarterial embolization. Urology 74:522–526

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the National Natural Science Foundation of China (Grant No. 81101717/H1611) and the Natural Science Foundation of Zhejiang Province (Grant No. Y2110120).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou, 310003, Zhejiang Province, China

    C. Wang, Q. Mao, F. Tan & B. Shen

Authors
  1. C. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Q. Mao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. B. Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Q. Mao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, C., Mao, Q., Tan, F. et al. Superselective renal artery embolization in the treatment of renal hemorrhage. Ir J Med Sci 183, 59–63 (2014). https://doi.org/10.1007/s11845-013-0972-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-013-0972-4

Keywords

Search

Navigation